Provider Demographics
NPI:1205895380
Name:LOYA-FRANK, LAURA E (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:LOYA-FRANK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-4042
Mailing Address - Country:US
Mailing Address - Phone:708-343-8512
Mailing Address - Fax:708-343-8529
Practice Address - Street 1:1350 W LAKE ST
Practice Address - Street 2:
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-4042
Practice Address - Country:US
Practice Address - Phone:708-343-8512
Practice Address - Fax:708-343-8529
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036086743207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036086943Medicaid
IL036086943Medicaid