Basic Information
| Provider Information | |||||||||
| NPI: | 1124141825 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOUGHLIN | ||||||||
| FirstName: | TERRENCE | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 698 FEATHERSTONE RD | ||||||||
| Address2: | |||||||||
| City: | ROCKFORD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 611076303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8153983277 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 698 FEATHERSTONE RD | ||||||||
| Address2: | |||||||||
| City: | ROCKFORD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 611076303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8153983277 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2007 | ||||||||
| LastUpdateDate: | 11/16/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 036064417 | IL | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.