MEDICARE: DR. MARY KATHLEEN LOCKARD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	036111319	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679571152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY KATHLEEN LOCKARD M.D.

Provider Business Mailing Address
First Line	:	PO BOX 556
Second Line	:
City	:	MACOMB
State	:	IL
Zip	:	61455-0556
Country	:	US
Telephone Number	:	309-833-3536
Fax Number	:	309-836-5729

Provider Business Practice Location Address
First Line	:	505 E GRANT ST
Second Line	:	SUITE 103
City	:	MACOMB
State	:	IL
Zip	:	61455-3352
Country	:	US
Telephone Number	:	309-833-3536
Fax Number	:	309-836-5729

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	06/30/2011

Similar Medicare Providers

1073518304 — DR. TROY D ECKMAN M.D.
Practice Location Address:

505 E GRANT ST
MACOMB, IL
61455-3352

Practice Phone: 309-833-5959
Practice Fax: 309-833-4969

1104821446 — SHARIE HARDEN CNM
Practice Location Address:

505 E GRANT ST
MACOMB, IL
61455-3352

Practice Phone: 309-833-5959
Practice Fax: 309-833-4969

1538164447 — BRENDA POWELL-ALLEN CWNP
Practice Location Address:

505 E GRANT ST
MACOMB, IL
61455-3352

Practice Phone: 309-833-5959
Practice Fax: 309-833-4969

1861497612 — DAVID L MILLER D.O.
Practice Location Address:

505 E GRANT ST , STE 103
MACOMB, IL
61455-3352

Practice Phone: 309-833-3536
Practice Fax: 309-836-5729

1508850694 — IDOL RAY MITCHELL DPM
Practice Location Address:

437 EAST GRANT STREET
MACOMB, IL
61455-3352

Practice Phone: 309-837-3964
Practice Fax: 309-837-3966

1477536993 — MR. MICHAEL LEE WATERS MD
Practice Location Address:

505 E GRANT ST , SUITE 110
MACOMB, IL
61455-3352

Practice Phone: 309-833-1733
Practice Fax: 309-836-2369

Directions to “ DR. MARY KATHLEEN LOCKARD M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.