Individual
VICTORIA ELIZABETH LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12629 S JUSTINE ST, CALUMET PARK, IL 60827-6009
(773) 620-2649
Mailing address
12629 S JUSTINE ST, CALUMET PARK, IL 60827-6009
(773) 620-2649
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99499
—
IL
05
—
99501
—
IL
Enumeration date
02/27/2025
Last updated
02/27/2025
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