Individual
LAUREN S LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9204
(262) 329-1000
(262) 329-1001
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
28257
WI
207RP1001X
Pulmonary Disease Physician
28257
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290011047
RR MEDICARE
—
05
—
31398900
—
WI
Enumeration date
04/14/2006
Last updated
10/04/2023
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