Individual
MR. DANIEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LCSW
Contact information
Practice address
2542 W NORTH AVE, CHICAGO, IL 60647-5216
(773) 365-7277
(773) 365-3091
Mailing address
2542 W NORTH AVE, CHICAGO, IL 60647-5216
(773) 365-7277
(773) 365-3091
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
149.014904
IL
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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