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Individual

DR. AMAYA LOPEZ BUSTINDUY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
836 W WELLINGTON AVE, ROOM 3612, CHICAGO, IL 60657-5147
(773) 296-5673
Mailing address
447 N LOMBARD AVE APT 3, OAK PARK, IL 60302-2498
(708) 660-9327

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36115192
IL

Other

Enumeration date
07/17/2006
Last updated
07/08/2007
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