Individual
ANA MICHELLE MENDOZA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(312) 864-6000
Mailing address
3134 NORMANDY RD, INDIANAPOLIS, IN 46222-1375
(317) 646-7444
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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