Individual
NICOLE LOPEZ PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(312) 996-2107
Mailing address
840 S WOOD ST STE 1222, CHICAGO, IL 60612-4325
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036176436
IL
Other
Enumeration date
04/10/2019
Last updated
09/26/2025
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