Provider Demographics
NPI:1780604314
Name:SINGER, JONAS (MD)
Entity type:Individual
Prefix:
First Name:JONAS
Middle Name:
Last Name:SINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 COMPASS POINT DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-4405
Mailing Address - Country:US
Mailing Address - Phone:636-947-4480
Mailing Address - Fax:
Practice Address - Street 1:300 FIRST CAPITOL DRIVE
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301
Practice Address - Country:US
Practice Address - Phone:636-947-5444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR2J632085R0202X
IL0360801742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036080174Medicaid
MO208893628Medicaid
MOP00100993OtherRAILROAD MEDICARE
MOMA3859002Medicare PIN
MO208893628Medicaid
E40143Medicare UPIN
MO917850350Medicare ID - Type UnspecifiedMO MEDICARE