Lopez, Ivan R

Lopez, Ivan R is an individual health care provider with primary practice located at 2003 Montgomery Rd Suite 106, Aurora IL 60504-9078. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Lopez, Ivan R can be contacted via phone (630) 340-4211.

Contact Information

Primary practice address
2003 Montgomery Rd Suite 106 Aurora IL 60504-9078
Phone: (630) 340-4211
Fax: (630) 340-3283
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036109448 Illinois

Profile Details

NPI number 1992845069
LBN Legal business name Lopez, Ivan R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2007
Last updated Jun 20th, 2012 - about 14 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 1992845069 NPPES
Illinois Other 02205538 BCBS PROVIDER NUMBER
Illinois Other 363950044 BCBS PROVIDER NUMBER
Illinois MEDICAID 036109448 BCBS PROVIDER NUMBER

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