Basic Information
| Provider Information | |||||||||
| NPI: | 1629384136 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JALIL | ||||||||
| FirstName: | YOUSAF | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 955534 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631955534 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 711 VETERANS MEMORIAL PKWY STE 300 | ||||||||
| Address2: | |||||||||
| City: | SAINT CHARLES | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633032106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6366692350 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2010 | ||||||||
| LastUpdateDate: | 10/22/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036128514 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 2020004472 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.