Individual
JENICE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
77 RAND RD, DES PLAINES, IL 60016-1005
(847) 296-3040
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209-021901
IL
363LF0000X
Family Nurse Practitioner
Primary
209021901
IL
Other
Enumeration date
09/01/2020
Last updated
10/16/2023
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