Provider Demographics
NPI:1992746903
Name:WASHINGTON UNIVERSITY
Entity type:Organization
Organization Name:WASHINGTON UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR MANAGED CARE
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:EGHIGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-273-0770
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:314-273-0770
Mailing Address - Fax:
Practice Address - Street 1:660 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1010
Practice Address - Country:US
Practice Address - Phone:314-747-5192
Practice Address - Fax:314-286-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO673341OtherAETNAHMOGROUP
MO3688OtherGHPMASTERVENDORNUMBER
MO552927808Medicaid
MO603025305Medicaid
IL92215194OtherBLUECROSS/BLUESHIELD-IL
MO603025305Medicaid
MOCC9951Medicare PIN
MOCH6646Medicare PIN
ILDC2004Medicare PIN
MO3688OtherGHPMASTERVENDORNUMBER
MOCQ4035Medicare UPIN
MO552927808Medicaid
MO673341OtherAETNAHMOGROUP
MOCC6123Medicare PIN
IL205476Medicare PIN
MO000010183Medicare PIN
MOCQ2042Medicare PIN
MO000012057Medicare PIN
ILDC7875Medicare PIN