Provider Demographics
NPI:1376830901
Name:LOY, STEPHANIE ANNE (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANNE
Last Name:LOY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:101 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3981
Mailing Address - Country:US
Mailing Address - Phone:217-366-1250
Mailing Address - Fax:217-398-2976
Practice Address - Street 1:3101 FIELDS SOUTH DR
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-3743
Practice Address - Country:US
Practice Address - Phone:217-366-1250
Practice Address - Fax:217-398-2976
Is Sole Proprietor?:No
Enumeration Date:2011-07-04
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010448152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist