| Illumination Health, LLC | |
|
2355 Dougherty Ferry Rd Ste 410 Saint Louis MO 63122-3325 | |
| (314) 835-4873 | |
| (314) 336-6475 |
| Full Name | Illumination Health, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2355 Dougherty Ferry Rd Ste 410, Saint Louis, Missouri |
| Authorized Official Name and Position | James Snider (V.P. PHYSICIAN NETWORK) |
| Authorized Official Contact | 6366857804 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Illumination Health, LLC 121 Saint Lukes Center Dr Chesterfield MO 63017-3518 Ph: (636) 685-7804 | Illumination Health, LLC 2355 Dougherty Ferry Rd Ste 410 Saint Louis MO 63122-3325 Ph: (314) 835-4873 |
| NPI Number | 1992378384 |
|---|---|
| Provider Enumeration Date | 07/22/2021 |
| Last Update Date | 03/05/2026 |
| Certification Date | 03/05/2026 |
| Medicare PECOS PAC ID | 9032517099 |
|---|---|
| Medicare Enrollment ID | O20211006001811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992378384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 2083B0002X | Preventive Medicine - Obesity Medicine | () | Secondary |
| Provider Name | Kristina a Potts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356747513 PECOS PAC ID: 2961710363 Enrollment ID: I20151005002442 |
| Provider Name | Sara I Hawatmeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710368584 PECOS PAC ID: 5092017848 Enrollment ID: I20190606001908 |
St. Louis Center for Preventive and Longevity Medicine, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 777 S New Ballas Rd, Suite 200 E, Saint Louis, MO 63141 Phone: 314-994-1536 Fax: 314-692-0241 |
Town and Country Primary Care LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3009 N Ballas Rd, Suite 300a, Saint Louis, MO 63131 Phone: 314-872-8999 |
Family Care Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 Lynch St, Saint Louis, MO 63118 Phone: 314-531-5444 Fax: 314-531-0063 |
Wusm Bjc Aco Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Euclid Ave, Campus Box 8081, Saint Louis, MO 63110 Phone: 314-273-0770 |
Victus Physician Services, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12607 Olive Blvd, Saint Louis, MO 63141 Phone: 314-327-8070 |
Salvation Army Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2900 Washington Ave, Saint Louis, MO 63103 Phone: 314-898-1700 Fax: 314-814-8542 |