| Howard Jay Ilivicky, MD | |
|
330 1st Capitol Dr, Ste 390, Saint Charles, MO 63301-2852 | |
| (636) 949-5760 | |
| (636) 949-0729 |
| Full Name | Howard Jay Ilivicky |
|---|---|
| Gender | Male |
| Speciality | Psychiatry |
| Experience | 36 Years |
| Location | 330 1st Capitol Dr, Saint Charles, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093711152 | NPI | - | NPPES |
| 122112 | Other | BLUE CROSS BLUE SHIELD | |
| 415921 | Other | HEALTHLINK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 118786 (Missouri) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD61660624 (Washington) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Greenbrook Tms St Louis Llc | 4284985417 | 10 |
| Mindful Health Solutions Wa Pc | 7911382072 | 8 |
| Entity Name | Psychiatric Care And Research Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447537071 PECOS PAC ID: 3678710506 Enrollment ID: O20130513000241 |
| Entity Name | Greenbrook Tms St Louis Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144713884 PECOS PAC ID: 4284985417 Enrollment ID: O20181105000980 |
| Mailing Address | Practice Location Address |
|---|---|
| Howard Jay Ilivicky, MD 4132 Keaton Crossing Blvd, Ste 201, O Fallon, MO 63368-8222 Ph: (636) 244-3589 | Howard Jay Ilivicky, MD 330 1st Capitol Dr, Ste 390, Saint Charles, MO 63301-2852 Ph: (636) 949-5760 |
Dr. Michele A Wood, D.O. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 400 1st Capitol Dr, Saint Charles, MO 63301 Phone: 636-946-1152 Fax: 636-946-8126 | |
Dr. Min Pan, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 400 1st Capitol Dr, Suite 407, Saint Charles, MO 63301 Phone: 636-946-1152 Fax: 636-946-8126 | |
Gregory Warren Mattingly, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 330 1st Capitol Dr, Ste 390, Saint Charles, MO 63301 Phone: 636-949-5760 Fax: 636-949-0729 | |
Dr. Kanika Ravi Ramchandani, MBBS, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 102 Compass Point Dr, Saint Charles, MO 63301 Phone: 844-853-8937 | |
Richard Howard Anderson, M.D., PHD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 330 1st Capitol Dr, Ste 390, Saint Charles, MO 63301 Phone: 636-949-5760 Fax: 636-949-0729 |