Individual
KEITH ALAN LOPATKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7300 W COLLEGE DR, STE 1NW, PALOS HEIGHTS, IL 60463-1152
(708) 671-1374
(708) 671-1378
Mailing address
7300 W COLLEGE DR, STE 1NW, PALOS HEIGHTS, IL 60463-1152
(708) 671-1374
(708) 671-1378
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
01056082A
IN
207N00000X
Dermatology Physician
Primary
036-113547
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-113547
—
IL
Enumeration date
07/14/2006
Last updated
02/18/2013
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