Provider Demographics
NPI:1922081348
Name:CHAO, LEIGH C (MD)
Entity type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:C
Last Name:CHAO
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:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-362-9123
Mailing Address - Fax:314-747-9160
Practice Address - Street 1:11133 DUNN RD
Practice Address - Street 2:DEPT EMERGENCY MED
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6163
Practice Address - Country:US
Practice Address - Phone:314-362-9123
Practice Address - Fax:314-747-9160
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112947207P00000X
IL036.102496207P00000X
IL036102496207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036102496Medicaid
IL036102496-4Medicaid
MO203922026Medicaid
IL203922067Medicaid
MO203922026Medicaid
IL036102496Medicaid
MO014013210Medicare PIN
ILK06153Medicare ID - Type Unspecified
IL036102496-4Medicaid
MO017013211Medicare PIN