Individual
MOISES LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
4350 S CALIFORNIA AVE STE 2F, CHICAGO, IL 60632-1263
(312) 428-0734
Mailing address
4350 S CALIFORNIA AVE STE 2F, CHICAGO, IL 60632-1263
(312) 428-0734
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.105435
IL
Other
Enumeration date
11/26/2021
Last updated
04/07/2022
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