Provider Demographics
NPI:1093193443
Name:LOZANO, VERONICA V
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:V
Last Name:LOZANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 W NORTHWEST HWY STE 11
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2377
Mailing Address - Country:US
Mailing Address - Phone:224-531-3392
Mailing Address - Fax:
Practice Address - Street 1:830 W NORTHWEST HWY STE 11
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-2377
Practice Address - Country:US
Practice Address - Phone:224-531-3392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227016012390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program