Octavio M. Lopez MD SC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

OCTAVIO M. LOPEZ MD SC

Practice address

11315 S Harlem Ave
Worth, IL 60482-2025

Phone

(708) 448-8899

Fax

(708) 448-9988

NPI assigned

Apr 25, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Octavio M Lopez, MDNPI 1700881455

Title

President

Phone

(708) 448-8899

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Octavio Menelao Lopez, M.D.

  • Internal Medicine Physician
  • Worth, IL
  • NPI 1700881455
  Authorized official Same address or phone

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841419785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11315 S HARLEM AVE",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "604822025",
            "telephone_number": "708-448-8899",
            "fax_number": "708-448-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11315 S HARLEM AVE",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "604822025",
            "telephone_number": "708-448-8899",
            "fax_number": "708-448-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCTAVIO M. LOPEZ MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "OCTAVIO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-448-8899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Han Ngoc Nguyen
• Noor Nahhas,Inc (Gem Dental)
• Michele Lynn Nowak, LCPC
• Roberta Nyblom
• Bernard Owen O'Brien, DC
• Abena Owusu-Ansah, PHARMD
• Bobbie Pearson, OTR
• Courtney Allison Pechos, LCSW
• Lisa M Pertile, LCSW
• Deborah A Price-Brooks, BS, BIOLOGY: RBT

• Multi-Specialty Clinic/Center in Worth, IL
• Providers in Worth, IL by specialty
• Multi-Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.