Healthcare Provider Details

I. General information

NPI: 1407559875
Provider Name (Legal Business Name): HELEN LOLI-SLOAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HELEN LOLI

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18701 N 67TH AVE
GLENDALE AZ
85308-7100
US

IV. Provider business mailing address

338 W LE MARCHE AVE
PHOENIX AZ
85023-7428
US

V. Phone/Fax

Practice location:
  • Phone: 623-561-7279
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number011477
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number011477
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: