Organization
LOPEZ PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY LOPEZ DNP, CNP, FPA-APRN (CEO)
(312) 779-0920
Entity
Organization
Contact information
Practice address
11309 DISTINCTIVE DR, ORLAND PARK, IL 60467-9490
(312) 779-0920
Mailing address
16036 84TH PL, TINLEY PARK, IL 60487-7500
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
309016898
—
IL
Enumeration date
06/07/2024
Last updated
06/07/2024
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