Individual
ENRIQUE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
3843 W 63RD ST, CHICAGO, IL 60629-4623
(773) 884-2297
(773) 884-0003
Mailing address
3843 W 63RD ST, CHICAGO, IL 60629-4623
(773) 884-2297
(773) 884-0003
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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