EDMUNDO LOPEZ

ROUND LAKE, IL
NPI1639544620
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IL  18030)
Enumeration Date2015-12-02
Last Update Date2015-12-02
Business Address
-- EDMUNDO LOPEZ
31979 N FISH LAKE RD
ROUND LAKE, IL 60073-9517
Phone number: 847-546-6450
Mailing Address
-- EDMUNDO LOPEZ
31979 N FISH LAKE RD
ROUND LAKE, IL 60073-9517
Phone number: 847-546-6450
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