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General NPI Number Information
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NPI Number | 1841317799
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE, S.C.
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Dates
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Enumeration Date | 03/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4400 W 95TH ST SUITE 312
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City | OAK LAWN
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State | IL
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Zip | 60453-2654
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Country | US
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Telephone | 708-499-3160
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Fax | 708-499-1150
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Provider Business Mailing Address
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Address Line | 4400 W 95TH ST SUITE 312
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City | OAK LAWN
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State | IL
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Zip | 60453-2654
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Country | US
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Telephone | 708-499-3160
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Fax | 708-499-1150
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD LOPEZ MON
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Credential | M.D.
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Telephone | 708-499-3160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | IL
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