Individual provider Active NPI

Rosalba M Lopez de Vaughan, PH.D.

  • Acupuncturist
  • Palatine, IL
National Provider Identifier
1932316593
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Practice address
381 W Northwest Hwy
Successful Longevity Clinic
Palatine, IL 60067-2414
Phone
(847) 705-7199
Fax
(847) 705-7112
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X IL Primary

Addresses

Primary practice location

381 W Northwest Hwy
Successful Longevity Clinic
Palatine, IL 60067-2414

Mailing address

381 W Northwest Hwy
Successful Longevity Clinic
Palatine, IL 60067-2414
Phone (847) 705-7199

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
198-000154ILMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932316593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 W NORTHWEST HWY",
            "address_2": "SUCCESSFUL LONGEVITY CLINIC",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600672414",
            "telephone_number": "847-705-7199",
            "fax_number": "847-705-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 W NORTHWEST HWY",
            "address_2": "SUCCESSFUL LONGEVITY CLINIC",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600672414",
            "telephone_number": "847-705-7199",
            "fax_number": "847-705-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ DE VAUGHAN",
        "first_name": "ROSALBA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.