Organization Active NPI

Marcos a. Lopez, M.D, S.C.

  • Ophthalmology Physician
  • North Riverside, IL
National Provider Identifier
1225048135
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MARCOS A. LOPEZ, M.D, S.C.
Practice address
9005 W Cermak Rd
North Riverside, IL 60546-1017
Phone
(708) 442-8010
Fax
(708) 442-8009
NPI assigned
Aug 9, 2006
Last updated
Oct 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Authorized official

Name
Angela Fermin
Title
Financial Manager
Phone
(708) 442-8010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

9005 W Cermak Rd
North Riverside, IL 60546-1017

Mailing address

9005 W Cermak Rd
North Riverside, IL 60546-1017
Phone (708) 442-8010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040817000172 IL Part B Supplier - Clinic/Group Practice 1456324680 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL; N Riverside, IL

National Provider Directory

National Provider Directory

Locations

1431 N Western Ave
Ste 301
Chicago, IL 60622
Phone (773) 276-2272

Interoperability endpoints

  • Direct secure messaging: mlopez@malopezmd.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1225048135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9005 W CERMAK RD",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461017",
            "telephone_number": "708-442-8010",
            "fax_number": "708-442-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9005 W CERMAK RD",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461017",
            "telephone_number": "708-442-8010",
            "fax_number": "708-442-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCOS A. LOPEZ, M.D, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "FERMIN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "708-442-8010"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Riverside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.