Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fareesa Khan LLC

Organization Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician · NPI 1780923490

Fareesa Khan LLC is an Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2013.

Licensed in
MO
In the registry since
2013
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10004 Kennerly Rd Ste 255A
Saint Louis, MO 63128-2184
Phone: (314) 270-9880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician (primary) Taxonomy 207VF0040X · Licence 112917 (MO)

Record details

NPI number1780923490
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Fareesa Khan — Owner · (636) 675-3107
NPI enumeratedFebruary 1, 2013
Last updated in NPPESJuly 10, 2020
Certification dateJuly 10, 2020
Mailing addressPo Box 410085, Saint Louis, MO 63141-0085

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