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Individual

SONIA CHACKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 577-8000
Mailing address
3660 VISTA AVE, SAINT LOUIS, MO 63110-2540
(314) 977-6100
(314) 977-6164

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2010031163
MO

Other

Enumeration date
06/22/2007
Last updated
03/29/2011
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