Individual
KIMBERLY LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, CNP, FPA-APRN
Contact information
Practice address
16036 84TH PL, TINLEY PARK, IL 60487-7500
(708) 983-3934
Mailing address
11309 DISTINCTIVE DR, ORLAND PARK, IL 60467-9490
(312) 561-9596
(878) 201-9103
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
277002436
IL
363L00000X
Nurse Practitioner
F01211025
IL
363LF0000X
Family Nurse Practitioner
Primary
209022767
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
277002436
IL
Other
Enumeration date
01/27/2021
Last updated
05/14/2024
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