Lopez, Bertha A

Lopez, Bertha A is an individual health care provider with primary practice located at 1 Erie Ct 6040, Oak Park IL 60302-2566. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. Lopez, Bertha A can be contacted via phone (708) 386-1390.

Contact Information

Primary practice address
1 Erie Ct 6040 Oak Park IL 60302-2566
Phone: (708) 386-1390
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine 207VM0101X 036090643 Illinois
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036090643 Illinois

Profile Details

NPI number 1578582979
LBN Legal business name Lopez, Bertha A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Dec 31st, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578582979 NPPES
Illinois Other 207667 MEDICAER GROUP NUMBER
Illinois MEDICAID 36090643 MEDICAER GROUP NUMBER
Illinois Other 1621924 MEDICAER GROUP NUMBER

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