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General NPI Number Information
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NPI Number | 1376605733
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Entity Type | Organization
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Legal Business Name | PHYLLIS S LOEFF, MD. LTD
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 321 WOODLAND RD
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-5054
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Country | US
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Telephone | 847-432-5620
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Fax |
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Provider Business Mailing Address
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Address Line | 321 WOODLAND RD
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-5054
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Country | US
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Telephone | 847-432-5620
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHYLLIS S LOEFF
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Credential | M.D.
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Telephone | 847-432-5620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | IL
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