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Individual

DR. EUGENE P LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
901 BIESTERFIELD RD, SUITE 300, ELK GROVE VILLAGE, IL 60007-3392
(847) 437-9889
(847) 437-4149
Mailing address
PO BOX 807, ELK GROVE VILLAGE, IL 60009-0807
(847) 437-9889
(847) 437-4149

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31603457
BLUE CROSS BLUE SHIELD #
IL
Enumeration date
07/21/2005
Last updated
11/14/2007
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