Individual
XAN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
8700 31ST ST, BROOKFIELD, IL 60513-1000
(708) 485-1155
Mailing address
3715 WESLEY AVE, BERWYN, IL 60402-4025
(708) 336-8314
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160008438
IL
Other
Enumeration date
02/22/2023
Last updated
02/22/2023
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