Individual
LAURA LOPEZ SANTIBANEZ JACOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1725 W HARRISON ST STE 809, CHICAGO, IL 60612-3861
(224) 361-6247
Mailing address
1725 W HARRISON ST STE 809, CHICAGO, IL 60612-3861
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
246.000837
IL
Other
Enumeration date
09/08/2021
Last updated
10/28/2025
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