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NPI Code Detail

MEDICARE: JACKELIN LOPEZ

MEDICARE: JACKELIN 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
1183500000XPharmacist051308381IL

General Provider Information

NPI Number : 1902754617
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACKELIN LOPEZ
Provider Business Mailing Address
First Line : 17223 CHICAGO AVE
Second Line :
City : LANSING
State : IL
Zip : 60438-1205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4830 GRAND AVE
Second Line :
City : GURNEE
State : IL
Zip : 60031-2618
Country : US
Telephone Number : 847-662-2585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “ JACKELIN LOPEZ ” Practice Location

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