Provider Demographics
NPI:1568679926
Name:LOY, MATTHEW DENNIS (RPH)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:DENNIS
Last Name:LOY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 OAK HILL ST
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-4873
Mailing Address - Country:US
Mailing Address - Phone:309-862-1486
Mailing Address - Fax:
Practice Address - Street 1:1108 OAK HILL ST
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-4873
Practice Address - Country:US
Practice Address - Phone:309-862-1486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist