Individual
MARYAM LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
15300 WEST AVE STE 100A, ORLAND PARK, IL 60462-4600
(708) 226-2318
(708) 226-2319
Mailing address
15300 WEST AVE STE 100A, ORLAND PARK, IL 60462-4600
(708) 226-2318
(708) 226-2319
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209032068
IL
363LG0600X
Gerontology Nurse Practitioner
209032068
IL
Other
Enumeration date
07/29/2025
Last updated
12/22/2025
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