Individual provider Active NPI

Georgina Gonzalez Lopez, APN

  • Family Nurse Practitioner
  • Benton Harbor, MI
National Provider Identifier
1386918597
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277000954 Issued in IL
Practice address
1275 Mall Dr
Benton Harbor, MI 49022-2309
Phone
(269) 934-9123
NPI assigned
Mar 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 277000954 IL Primary

Addresses

Primary practice location

1275 Mall Dr
Benton Harbor, MI 49022-2309

Mailing address

1275 Mall Dr
Benton Harbor, MI 49022-2309
Phone (269) 934-9123

Other practice location 1

10855 Virginia St
Crown Point, IN 46307-0210
Phone (773) 702-1000

Other practice location 2

350 N Wall St
Kankakee, IL 60901-2901
Phone (815) 933-1671

Other names 1

  • Ms. Georgina Gonzalez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120530000507 IL Practitioner - Nurse Practitioner 8426211525 Reassigns benefits to 1 organization
I20240620003662 IN Practitioner - Nurse Practitioner 8426211525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

105 S 1St St
Willmington, IL 60481-8973
Phone (815) 476-5210

10855 Virginia St
Suite 1700
Crown Point, IN 46307-0210
Phone (888) 824-0200

400 S Kennedy Dr
Suite 200
Bradley, IL 60915-2686
Phone (815) 933-0007

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Chicago CurrentSince May 16, 2024 Accepting new patients
Riverside Health System CurrentSince Apr 22, 2013 Accepting new patients
Riverside Health System CurrentSince Apr 22, 2013 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

720 S Crescent St
Gilman, IL 60938
Phone (815) 265-4255

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

611 S Division St
Peotone, IL 60468
Phone (708) 258-9058

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

10855 Virginia St
Ste 2400
Crown Point, IN 46307

10855 Virginia St
Ste 1700
Crown Point, IN 46307

10855 Virginia St
Ste 2700
Crown Point, IN 46307

10855 Virginia St
Ste 2100
Crown Point, IN 46307
Phone (219) 407-5540

10855 Virginia St
Ste 1200
Crown Point, IN 46307
Phone (219) 407-5500

1500 S Lake Park Ave
Ste 109
Hobart, IN 46342
Phone (219) 942-0551

Interoperability endpoints

  • Direct secure messaging: glopez7394@direct.riversidehealthcare.net
  • Direct secure messaging: glopezapp309183@uchospital.direct-ci.com

Organizations & group practices 4

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1386918597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 MALL DR",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222309",
            "telephone_number": "269-934-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 MALL DR",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222309",
            "telephone_number": "269-934-9123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10855 Virginia St",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463070210",
            "country_code": "US",
            "telephone_number": "773-702-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 N Wall St",
            "address_purpose": "LOCATION",
            "city": "Kankakee",
            "state": "IL",
            "postal_code": "609012901",
            "country_code": "US",
            "telephone_number": "815-933-1671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "GEORGINA",
        "middle_name": "GONZALEZ",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277000954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GEORGINA",
            "last_name": "GONZALEZ",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Benton Harbor, MI

Sources for this page

Verify at the official NPI Registry.