Individual provider · Type 1 NPI

Amy Kathleen Licis, MD

Neurology Physician · St. Louis, MO

NPI number 1992914352 Active

Practice location

1600 S Brentwood Blvd, Div Neurology Sleep Med, Ste 600
St. Louis, MO 63144-1320

Call (314) 362-1408 Map

Fax (314) 747-4342

Mailing address

PO Box 7412011
Chicago, IL 60674-2011

Specialties and licenses

TaxonomyCodeLicense
Pediatric Sleep Medicine Physician 2080S0012X2009014878 (MO)
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X2009014878 (MO)
Neurology Physician Primary 2084N0400X2009014878 (MO)

Neurology Physician: A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

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About NPI 1992914352

Amy Kathleen Licis, MD's National Provider Identifier is 1992914352, issued on May 22, 2007. The primary taxonomy on file is Neurology Physician (2084N0400X), and the practice location is in St. Louis, MO. The record was last updated on Apr 17, 2025.