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Individual

DR. VANESSA RIVAS-LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1701 W SUPERIOR ST FL 2, CHICAGO, IL 60622
(312) 666-3494
Mailing address
1701 W SUPERIOR ST FL 3, CHICAGO, IL 60622-5646
(312) 666-3494

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-146157
IL
208000000X
Pediatrics Physician
036.146157
IL
208000000X
Pediatrics Physician
A140307
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036146157
IL
Enumeration date
07/23/2016
Last updated
08/10/2021
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