Individual
MR. CHARLES JOHN LOPEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5000 S 5TH AVE, ROUTING 121B, HINES, IL 60141-3030
(708) 202-8387
(708) 202-2008
Mailing address
5000 S 5TH AVE, ROUTING 121B, HINES, IL 60141-3030
(708) 202-8387
(708) 202-2008
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
211000139
IL
Other
Enumeration date
10/23/2008
Last updated
10/23/2008
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