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Individual

DAVID LOPEZ SANTOYO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3600 W FULLERTON AVE, CHICAGO, IL 60647-2319
(773) 782-2800
(773) 772-9105
Mailing address
1733 W 19TH ST, CHICAGO, IL 60608-2775
(773) 782-2800
(773) 772-9105

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
362167752
IL
Enumeration date
01/18/2016
Last updated
01/18/2016
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