| Jeffrey A. Vander Kooi Llc | |
|
16100 Chesterfield Pkwy W Ste 260 Chesterfield MO 63017-4836 | |
| (636) 778-9427 | |
| (636) 778-9632 |
| Full Name | Jeffrey A. Vander Kooi Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 16100 Chesterfield Pkwy W Ste 260, Chesterfield, Missouri |
| Authorized Official Name and Position | Jeffrey A. Vander Kooi (PSYCHIATRIST) |
| Authorized Official Contact | 3147049214 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey A. Vander Kooi Llc 16100 Chesterfield Pkwy W Ste 260 Chesterfield MO 63017-4836 Ph: (636) 778-9427 | Jeffrey A. Vander Kooi Llc 16100 Chesterfield Pkwy W Ste 260 Chesterfield MO 63017-4836 Ph: (636) 778-9427 |
| NPI Number | 1588772487 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 08/04/2022 |
| Certification Date | 08/04/2022 |
| Medicare PECOS PAC ID | 7911080973 |
|---|---|
| Medicare Enrollment ID | O20080213000698 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588772487 | NPI | - | NPPES |
| 201053204 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jeffrey A Vander Kooi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407881675 PECOS PAC ID: 5092720730 Enrollment ID: I20060216000085 |
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