Individual
KELLY P LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
105 SARAVANOS RD, YORKVILLE, IL 60560-5813
(630) 553-4600
(630) 553-7486
Mailing address
725 SCHOOL ST STE A, MORRIS, IL 60450-1207
(815) 941-9124
(815) 941-4363
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020409
IL
363LF0000X
Family Nurse Practitioner
209.020409
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.020409
IL LICENSE
IL
Enumeration date
11/18/2019
Last updated
07/29/2021
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