OrganizationActive
Fareesa Khan LLC
NPI 1780923490 · Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician · Saint Louis, MO
Provider details
- NPI number
- 1780923490
- Entity type
- Organization
- Primary specialty
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Fareesa Khan, Owner(636) 675-3107
- License
- 112917 (MO)
Specialties & taxonomies
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianPrimary207VF0040XLicense 112917 (MO)
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10004 Kennerly Rd Ste 255a
Saint Louis, MO 63128-2184
Phone: (314) 270-9880
Street-level locationGet directions
Mailing address
Po Box 410085
Saint Louis, MO 63141-0085
Registry dates
- Enumerated
- 2013-02-01
- Last updated
- 2020-07-10
- Certified
- 2020-07-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.