Organization
TYRRELL-LOPEZ, INC
Active
Other names
TLI
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYNN LOPEZ RN (PRESIDENT)
(630) 244-2080
Entity
Organization
Contact information
Practice address
4219 W 95TH ST, OAK LAWN, IL 60453-1294
(630) 946-0166
(630) 946-0170
Mailing address
931 W 75TH ST, 137302, NAPERVILLE, IL 60565-1294
(630) 946-0166
(630) 946-0170
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1010188
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
364470331001
DSCC MEDICAID
IL
01
—
381674
PROVIDER REFERENCE DHFS
IL
Enumeration date
01/31/2007
Last updated
10/08/2009
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