Individual
ELENA MARIA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 MAJOR DR, NORTHLAKE, IL 60164-1822
(773) 297-5843
Mailing address
401 MAJOR DR, NORTHLAKE, IL 60164-1822
(773) 297-5843
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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