Lopez, Luis A

Lopez, Luis A is an sole proprietor health care provider with primary practice located at 1000 W Deyoung St , Marion IL 62959-1630. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Lopez, Luis A can be contacted via phone (618) 993-5274.

Contact Information

Primary practice address
1000 W Deyoung St Marion IL 62959-1630
Phone: (618) 993-5274
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 036-103701 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036-103701 Illinois

Profile Details

NPI number 1861592065
LBN Legal business name Lopez, Luis A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2006
Last updated Mar 7th, 2023 - about 2 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 1861592065 NPPES
Illinois Other 036-103701 STATE LICENSE
Illinois Other 336-064402 STATE LICENSE

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