Provider Demographics
NPI:1811188949
Name:NASEER, KRISTINA (MD)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:NASEER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SAINT ELIZABETH BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-1281
Mailing Address - Country:US
Mailing Address - Phone:618-641-5803
Mailing Address - Fax:
Practice Address - Street 1:3 SAINT ELIZABETH BLVD STE 200
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-1281
Practice Address - Country:US
Practice Address - Phone:618-641-5803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01063556A207LP2900X
IL036.117801207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000530722OtherANTHEM BCBS
IL01063556AOtherBCBS OF ILLINOIS
IN200095110AMedicaid
IN01063556AOtherLICENSE NUMBER
GAP00421579OtherRAILROAD MEDICARE
IN5761568OtherAETNA
IN409950IMedicare PIN