Individual
ROBERT WALTER LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2109
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2109
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036167076
IL
Other
Enumeration date
04/18/2021
Last updated
10/17/2023
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