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IVAN R LOPEZ MD PC NPI 1740512359


NPI Information

NPI: 1740512359
Provider Name: IVAN R LOPEZ MD PC

Doing Business As: PROHEALTH MEDICAL CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 14D2004238

Address:
2003 MONTGOMERY RD
SUITE 106 107
AURORA, IL
ZIP 60504
Phone: (630) 340-4211
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IVAN R LOPEZ MD PC is a family medicine in Aurora, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. IVAN R LOPEZ MD PC NPI is 1740512359. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Prohealth Medical Center.

The provider's business location address is:

2003 MONTGOMERY RD
SUITE 106 107
AURORA, IL
ZIP 60504-078
Phone: (630) 340-4211

The provider's authorized official is Ivan Roger Lopez .
The authorized official title is Owner and has the following contact phone number (708) 890-9115.

The CLIA number assigned to this NPI record is 14D2004238 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/6/2010 and was last updated on 6/20/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine036109448ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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