MEDICARE: TERRENCE P. LOOBY,D.D.S.

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	1223G0001X	General Practice Dentistry		IL

General Provider Information

NPI Number	:	1700058401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERRENCE P. LOOBY,D.D.S.

Provider Business Mailing Address
First Line	:	7310 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60634-3531
Country	:	US
Telephone Number	:	773-622-6139
Fax Number	:	773-622-6199

Provider Business Practice Location Address
First Line	:	7310 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60634-3531
Country	:	US
Telephone Number	:	773-622-6139
Fax Number	:	773-622-6199

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TERRENCE PATRICK LOOBY
Credential	:	D.D.S.
Telephone Number	:	773-844-5666

Provider Enumeration Date	:	04/02/2008
Last Update Date	:	04/02/2008

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Directions to “TERRENCE P. LOOBY,D.D.S. ” Practice Location

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