Individual
DR. STEFANI STEVANIJA TICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV PED GASTRO, HEPATOLOGY AND NUTRITION, SAINT LOUIS, MO 63110-1002
(314) 454-6173
(844) 231-8912
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-6173
(844) 231-8912
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2020013471
MO
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
2020013471
MO
2080P0206X
Pediatric Gastroenterology Physician
Primary
01094083A
IN
2080P0206X
Pediatric Gastroenterology Physician
Primary
2020013471
MO
208M00000X
Hospitalist Physician
2020013471
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200061929
—
MO
Enumeration date
06/23/2017
Last updated
05/29/2026
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