1336633494 NPI number — MS. ALLISON R SHKLAR AUD

Table of content: MS. ALLISON R SHKLAR AUD (NPI 1336633494)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336633494 NPI number — MS. ALLISON R SHKLAR AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHKLAR
Provider First Name:
ALLISON
Provider Middle Name:
R
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
AUD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336633494
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7412011
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60674-2011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-362-7509
Provider Business Mailing Address Fax Number:
314-453-0489

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 N NEW BALLAS RD
Provider Second Line Business Practice Location Address:
DEPT OTOLARYNGOLOGY, STE 140
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63141-6859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-362-7509
Provider Business Practice Location Address Fax Number:
314-453-0489
Provider Enumeration Date:
06/21/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  2018025887 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 330076501 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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