Linda Sara Lopez

Individual provider Active NPI Developmental Therapist · Volo, IL

NPI 1194558882 · NPPES record last updated Aug 20, 2024

Key facts

NPI
1194558882
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
1400 Wentworth Dr
Volo, IL 60020-3415
Phone
(847) 361-7611
NPI assigned
Aug 20, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
222Q00000X Yes

Addresses

Primary practice location

1400 Wentworth Dr
Volo, IL 60020-3415

Mailing address

1400 Wentworth Dr
Volo, IL 60020-3415
Phone (847) 361-7611

Other providers in Volo, IL

All providers in Volo, IL · Developmental Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.