Individual
CRISTINA IVETTE OLIVAS CHACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6031
(314) 251-6343
Mailing address
11475 OLDE CABIN RD STE 200, SAINT LOUIS, MO 63141-7129
(314) 991-8210
(314) 991-8206
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
2025036598
MO
2085R0202X
Diagnostic Radiology Physician
Primary
2025036598
MO
2085R0202X
Diagnostic Radiology Physician
45807
OK
2085R0202X
Diagnostic Radiology Physician
D90924
MD
Other
Enumeration date
06/17/2016
Last updated
10/06/2025
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