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NPI Code Detail

MEDICARE: RAUL ANTONIO PEREZ LOPEZ

MEDICARE: RAUL ANTONIO PEREZ LOPEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDN31901FL

General Provider Information

NPI Number : 1083549745
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAUL ANTONIO PEREZ LOPEZ
Provider Business Mailing Address
First Line : 3450 LACEY RD
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5430
Country : US
Telephone Number : 630-743-4500
Fax Number :
Provider Business Practice Location Address
First Line : 3450 LACEY RD
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5430
Country : US
Telephone Number : 630-743-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “ RAUL ANTONIO PEREZ LOPEZ ” Practice Location

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