Basic Information
| Provider Information | |||||||||
| NPI: | 1760044101 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABD EL NOUR | ||||||||
| FirstName: | MONICA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 CHILDRENS PL MSC 8116-0043-08 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3144546050 | ||||||||
| FaxNumber: | 3144542836 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 CHILDRENS PL MSC 8116-0043-08 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3144546050 | ||||||||
| FaxNumber: | 3144542836 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2019 | ||||||||
| LastUpdateDate: | 06/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 2022024166 | MO | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 125075165 | IL | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.