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1134875057
LICIA LOPEZ
CHICAGO, IL
NPI
1134875057
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 125.081537)
Enumeration Date
2022-03-01
Last Update Date
2023-06-21
Business Address
LICIA LOPEZ DO
4600 N RAVENSWOOD AVE
CHICAGO, IL 60640-4510
Phone number: 773-561-7500
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Mailing Address
LICIA LOPEZ DO
4600 N RAVENSWOOD AVE
CHICAGO, IL 60640-4510
Phone number: 773-561-7500
Copy
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