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General NPI Number Information
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NPI Number | 1952784605
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Entity Type | Individual
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Provider Name | MONICA C LOPEZ FPA-APRN
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Gender | Female
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 4840 W BYRON ST
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City | CHICAGO
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State | IL
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Zip | 60641-2712
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Country | US
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Telephone | 773-282-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 4840 W BYRON ST
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City | CHICAGO
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State | IL
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Zip | 60641-2712
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Country | US
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Telephone | 773-282-8000
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Fax |
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 277.003682
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277.003682
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License Number State | IL
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