Provider Demographics
NPI:1528747599
Name:DRYER, ANNCLAIRE
Entity type:Individual
Prefix:
First Name:ANNCLAIRE
Middle Name:
Last Name:DRYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNCLAIRE
Other - Middle Name:
Other - Last Name:MCGEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:143-434-4403
Mailing Address - Fax:314-343-4439
Practice Address - Street 1:12445 DORSETT RD
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-3907
Practice Address - Country:US
Practice Address - Phone:314-343-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024040352363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant