Provider Demographics
NPI:1255482881
Name:LOPEZ, NORMA A (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:A
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NORMA
Other - Middle Name:A
Other - Last Name:LOPEZ-SHAAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1525 S SANGAMON ST
Mailing Address - Street 2:UNIT 716
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1069
Mailing Address - Country:US
Mailing Address - Phone:312-636-5839
Mailing Address - Fax:
Practice Address - Street 1:2106 S 1ST AVE
Practice Address - Street 2:ENDOCRINOLOGY DEPARTMENT
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3304
Practice Address - Country:US
Practice Address - Phone:708-216-0160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36113787207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine