Provider Demographics
NPI:1508077017
Name:LOCHARD, LES G (MD)
Entity Type:Individual
Prefix:DR
First Name:LES
Middle Name:G
Last Name:LOCHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 S. RANDALL RD.
Mailing Address - Street 2:SUITE C-141
Mailing Address - City:ST.CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174
Mailing Address - Country:US
Mailing Address - Phone:163-024-4340
Mailing Address - Fax:
Practice Address - Street 1:902 S RANDALL RD
Practice Address - Street 2:SUITE C-141
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1554
Practice Address - Country:US
Practice Address - Phone:630-244-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036057433207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BL1990363OtherDEA NUMBER
C51628Medicare UPIN