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1891221958
ANTHONY LOPEZ
CRESTWOOD, IL
NPI
1891221958
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Other Name
TONY LOPEZ
Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
405300000X Prevention Professional
(Licence: IL 2000026450)
Enumeration Date
2017-05-11
Last Update Date
2017-05-11
Business Address
-- ANTHONY LOPEZ ATC
14011 KENTON AVE
CRESTWOOD, IL 60445-2252
Phone number: 219-794-4653
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Mailing Address
-- ANTHONY LOPEZ ATC
5750 ABBEY DR APT 2C
LISLE, IL 60532-2582
Phone number: 309-721-6705
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