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

Iconic Services Inc

Organization Sports Medicine (Family Medicine) Physician · NPI 1750872354

Iconic Services Inc is a Sports Medicine (Family Medicine) Physician in Saint Louis, Missouri. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4625 Lindell Blvd Ste 200
Saint Louis, MO 63108-3729
Phone: (314) 437-8932
Fax: (888) 749-2228
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X

Record details

NPI number1750872354
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Christine Cordero — Manager · (314) 437-8932
NPI enumeratedMay 21, 2018
Last updated in NPPESMay 21, 2018
Mailing address4625 Lindell Blvd Ste 200, Saint Louis, MO 63108-3729

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