Provider Demographics
NPI:1598381220
Name:GREGERSEN, MAREN KRISTINE (MD)
Entity type:Individual
Prefix:DR
First Name:MAREN
Middle Name:KRISTINE
Last Name:GREGERSEN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-286-1967
Mailing Address - Fax:314-747-3342
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV NEUROLOGY AGING AND DEMENTIA, STE 6C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-286-1967
Practice Address - Fax:314-747-3342
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20240283692084N0400X
MO20200175342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology