MEDICARE: KEITH ALAN LOPATKA M.D.

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
1	207N00000X	Dermatology Physician	036-113547	IL
2	207N00000X	Dermatology Physician	01056082A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770509648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH ALAN LOPATKA M.D.

Provider Business Mailing Address
First Line	:	7300 W COLLEGE DR
Second Line	:	STE 1NW
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1152
Country	:	US
Telephone Number	:	708-671-1374
Fax Number	:	708-671-1378

Provider Business Practice Location Address
First Line	:	7300 W COLLEGE DR
Second Line	:	STE 1NW
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1152
Country	:	US
Telephone Number	:	708-671-1374
Fax Number	:	708-671-1378

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	02/18/2013

Similar Medicare Providers

1891786067 — DR. EUGENE MANDREA M.D.
Practice Location Address:

7300 W COLLEGE DR , SUITE 1NW
PALOS HEIGHTS, IL
60463-1152

Practice Phone: 708-671-1374
Practice Fax: 708-671-1378

1184615387 — EUGENE MANDREA, M.D., S.C.
Practice Location Address:

7300 W COLLEGE DR , SUITE1NW
PALOS HEIGHTS, IL
60463-1152

Practice Phone: 708-671-1374
Practice Fax: 708-671-1378

1063497345 — PALOS PSYCHIATRIC & RECOVERY INST LTD
Practice Location Address:

7300 W COLLEGE DR , 101
PALOS HEIGHTS, IL
60463-1152

Practice Phone: 708-448-8470
Practice Fax: 708-448-9651

1609851740 — NORTH SHORE WELLNESS CENTER LTD
Practice Location Address:

7300 W COLLEGE DR , SUITE 101
PALOS HEIGHTS, IL
60463-1152

Practice Phone: 708-448-8470
Practice Fax: 708-448-9651

1639134224 — MS. DANIELLE P GLICKLEY LSW
Practice Location Address:

7300 W COLLEGE DR , 101
PALOS HEIGHTS, IL
60463-1152

Practice Phone: 708-448-8470
Practice Fax: 708-448-9651

1831110279 — MRS. BERNICE IK-JANG MI JOHNSON PHYISICAN ASSISTANT
Practice Location Address:

7300 W COLLEGE DR , 1NW
PALOS HEIGHTS, IL
60463-1152

Practice Phone: 708-671-1374
Practice Fax: 708-671-1378

Directions to “ KEITH ALAN LOPATKA M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.