Individual provider Active NPI

Josh Lopez

  • Family Nurse Practitioner
  • Elgin, IL
National Provider Identifier
1184166001
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277.000904 Issued in IL
Practice address
1665 Larkin Ave
Elgin, IL 60123-5977
Phone
(847) 695-1093
Fax
(847) 695-0501
NPI assigned
Nov 9, 2016
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209015033 IL
Family Nurse Practitioner 363LF0000X 277.000904 IL Primary

Addresses

Primary practice location

1665 Larkin Ave
Elgin, IL 60123-5977

Mailing address

4025 N Sheridan Rd
Chicago, IL 60613-2010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161130000098 IL Practitioner - Nurse Practitioner 6800176363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1665 Larkin Ave
Elgin, IL 60123-5977
Phone (847) 695-1093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
277.000904ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Clinic Family CurrentSince Jan 29, 2021 Accepting new patients
Open Door Clinic of Greater Elgin CurrentSince Jan 29, 2021 Accepting new patients
Howard Brown Health Center CurrentSince Dec 1, 2016 Accepting new patients
Howard Brown Health Center CurrentSince Dec 1, 2016 Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

157 S Lincoln Ave
Ste K
Aurora, IL 60505
Phone (847) 695-1093

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

1665 Larkin Ave
Elgin, IL 60123
Phone (847) 695-1093

Interoperability endpoints

  • Direct secure messaging: joshua.lopez.1@17509.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1184166001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 LARKIN AVE",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235977",
            "telephone_number": "847-695-1093",
            "fax_number": "847-695-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOSH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-09",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015033",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277.000904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.