Ssm Cardinal Glennon Childrens Hospital

NPI #1174577670 in O Fallon, Illinois

Provider Information

NPI Number: 1174577670
Entity Type: Organization
Organization Name: Ssm Cardinal Glennon Childrens Hospital
Subpart: Yes (part of a larger organization)
Parent Organization: SSM CARDINAL GLENNON CHILDRENS HOSPITAL
Primary Specialty: Pediatrics
Enumeration Date: May 19, 2006
Last Updated: Sep 30, 2020

Practice Location

Address: 1 SAINT ELIZABETH BLVD
City: O Fallon
State: Illinois
ZIP Code: 62269-1099
Phone: (618) 234-2120

Authorized Official

Name: KAREN REWERTS
Title: VP FINANCE
Phone: (314) 989-2034

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychiatry & Neurology - Psychiatry — Psychiatry	2084P0800X
Radiology - Body Imaging — Body Imaging	2085B0100X
Psychologist	103T00000X
Social Worker	104100000X
Pathology - Cytopathology — Cytopathology	207ZC0500X
Pediatrics - Obesity Medicine — Obesity Medicine	2080B0002X
Pediatrics	208000000X	Primary

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Saba Bajwa, MD	Pediatrics	O Fallon	AI Deep Dive
DR. Kevin M Ponciroli, M.D.	Pediatrics	O Fallon	AI Deep Dive
Emily Caufield, CPNP-PC	Pediatrics	O Fallon	AI Deep Dive
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Organizations

Provider Name	Specialty	City
Redbird Pediatrics, Pllc	Pediatrics	O Fallon	AI Deep Dive

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