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General NPI Number Information
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NPI Number | 1295880425
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Entity Type | Individual
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Provider Name | KRISTOPHER M LOPEZ DPM
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 3632 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60618-4715
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Country | US
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Telephone | 773-248-4111
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Fax | 773-248-4450
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Provider Business Mailing Address
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Address Line | 3632 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60618-4715
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Country | US
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Telephone | 773-248-4111
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Fax | 773-248-4450
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016.005291
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016005291
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License Number State | IL
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