Provider Demographics
NPI:1619976396
Name:LOEB, BARBARA B (MD)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:B
Last Name:LOEB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3825 HIGHLAND AVE
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1552
Mailing Address - Country:US
Mailing Address - Phone:630-963-9667
Mailing Address - Fax:630-963-9936
Practice Address - Street 1:3825 HIGHLAND AVE
Practice Address - Street 2:SUITE 5B
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1552
Practice Address - Country:US
Practice Address - Phone:630-963-9667
Practice Address - Fax:630-963-9936
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02222422OtherBCBS PROVIDER NUMBER
IL02222422OtherBCBS PROVIDER NUMBER
ILL66824Medicare ID - Type UnspecifiedMCR PROVIDER NUMBER