Provider Demographics
NPI:1124000104
Name:HABIB, ASIF (MD)
Entity type:Individual
Prefix:DR
First Name:ASIF
Middle Name:
Last Name:HABIB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 N NEW BALLAS RD STE 334
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6840
Mailing Address - Country:US
Mailing Address - Phone:314-989-0542
Mailing Address - Fax:314-989-0559
Practice Address - Street 1:522 N NEW BALLAS RD STE 334
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6840
Practice Address - Country:US
Practice Address - Phone:314-989-0542
Practice Address - Fax:314-989-0559
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1142592084P0800X
IL0361006802084P0800X
IL0361006302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203828439Medicaid
ILL82157Medicare ID - Type Unspecified