MEDICARE: DR. STEVEN RAY LOBACZ MD

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	2084P0800X	Psychiatry Physician	036-098563	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	:	1558328955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN RAY LOBACZ MD

Provider Business Mailing Address
First Line	:	PO BOX 268312
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-8312
Country	:	US
Telephone Number	:	773-764-5135
Fax Number	:	773-764-4967

Provider Business Practice Location Address
First Line	:	1545 W MORSE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-3306
Country	:	US
Telephone Number	:	773-764-5135
Fax Number	:	773-764-4967

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

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	04/16/2010

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