Provider Demographics
NPI:1033905716
Name:ST PHARD, LUDLEY E (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:LUDLEY
Middle Name:E
Last Name:ST PHARD
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E BUTTERFIELD RD # 440
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-7200
Mailing Address - Country:US
Mailing Address - Phone:954-805-0210
Mailing Address - Fax:
Practice Address - Street 1:205 E BUTTERFIELD RD # 440
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-7200
Practice Address - Country:US
Practice Address - Phone:954-805-0210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care