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Individual

DR. MARCOS ANTONIO LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9005 W CERMAK RD, NORTH RIVERSIDE, IL 60546-1017
(708) 442-8010
(708) 442-8009
Mailing address
9005 W CERMAK RD, NORTH RIVERSIDE, IL 60546-1017
(708) 442-8010
(708) 442-8009

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036092620
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036092620
IL
Enumeration date
08/09/2006
Last updated
07/08/2007
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