Organization
HEARTLAND PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS ALBERTO LOPEZ M.D. (PRESIDENT/PHYSICIAN)
(618) 993-5274
Entity
Organization
Contact information
Practice address
1000 W DEYOUNG ST, MARION, IL 62959-1630
(618) 993-5274
(618) 999-0639
Mailing address
PO BOX 1866, MARION, IL 62959-8066
(618) 993-5274
(618) 993-0639
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/02/2006
Last updated
09/01/2020
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