Amy Kathleen Licis, MD

Neurology Physician · Saint Louis, MO

Individual Active NPI

NPI number 1992914352

Practice location

1600 S Brentwood Blvd
Div Neurology Sleep Med, Ste 600
Saint Louis, MO 63144-1320
Phone
(314) 362-1408
Fax
(314) 747-4342

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NPI record

NPI
1992914352
Entity type
Individual (Type 1)
Enumeration date
May 22, 2007
Last updated
April 17, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Neurology Physician Primary 2084N0400X 2009014878 MO
Pediatric Sleep Medicine Physician 2080S0012X 2009014878 MO
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 2009014878 MO

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone
(314) 362-1408
Fax
(314) 747-4342

About Dr. Licis

Amy Kathleen Licis, MD is a healthcare provider registered in the NPI registry with the primary taxonomy Neurology Physician (code 2084N0400X). The practice location is 1600 S Brentwood Blvd, Div Neurology Sleep Med, Ste 600, Saint Louis, MO 63144-1320. The NPI number 1992914352 was assigned on May 22, 2007 and the record was last updated on April 17, 2025.

Dr. Licis lists 3 licenses in the registry: #2009014878 (MO) for Neurology Physician; #2009014878 (MO) for Pediatric Sleep Medicine Physician; #2009014878 (MO) for Neurology with Special Qualifications in Child Neurology Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Amy Kathleen Licis, MD?

The NPI number is 1992914352.

What is the phone number of Dr. Licis?

The phone number listed for the practice location is (314) 362-1408.

Where is Dr. Licis located?

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

What is the taxonomy code for Dr. Licis?

The primary taxonomy code is 2084N0400X – Neurology Physician; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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