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

Signature Medical Group, Inc

Organization Allergy Physician · NPI 1871542761

Signature Medical Group, Inc is an Allergy Physician in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2006.

Licensed in
MO
In the registry since
2006
Specialties on file
11
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

12639 Old Tesson Rd Ste 115
Saint Louis, MO 63128-2786
Phone: (314) 849-0311
Fax: (314) 849-4423
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X
Allergy Physician Taxonomy 207KA0200X
Dermatology Physician Taxonomy 207N00000X (MO)
Gastroenterology Physician Taxonomy 207RG0100X (MO)
Neurological Surgery Physician Taxonomy 207T00000X (MO)
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Gynecologic Oncology Physician Taxonomy 207VX0201X (MO)
Pediatrics Physician Taxonomy 208000000X (MO)
Pain Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P2900X
Surgery Physician Taxonomy 208600000X (MO)
Colon & Rectal Surgery Physician Taxonomy 208C00000X (MO)

Record details

NPI number1871542761
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chad Sackman — Ceo · (314) 849-0311
NPI enumeratedMay 8, 2006
Last updated in NPPESAugust 8, 2024
Certification dateAugust 1, 2024
Mailing address12639 Old Tesson Rd, Suite 115, Saint Louis, MO 63128-2786

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