Active NPI
Michael Lopez
- Nutritionist
- Chicago, IL
National Provider Identifier
1013370519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 1011
- Practice address
- 111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597 - Phone
- (312) 734-1001
- NPI assigned
- Apr 1, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 1011 | ND | Primary |
Addresses
Primary practice location
111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597
Mailing address
111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1011 | ND | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459468800000",
"number": "1013370519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 W JACKSON BLVD STE 1700",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606043597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 W JACKSON BLVD STE 1700",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606043597",
"telephone_number": "312-734-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-01",
"last_updated": "2016-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "ND",
"license": "1011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.