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

Dr. Russell John Chlysta

Individual provider Internal Medicine Physician · NPI 1811603996

Dr. Russell John Chlysta is an Internal Medicine Physician in Florissant, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2023
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Practice location Address checks out

11115 New Halls Ferry Rd Ste 105
Florissant, MO 63033-7610
Phone: (314) 921-6200
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Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 2014042897 (MO)

Record details

NPI number1811603996
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 23, 2023
Last updated in NPPESJanuary 23, 2023
Certification dateJanuary 23, 2023
Mailing address12411 Bennett Springs Ct Apt L, Saint Louis, MO 63146-3939

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