| Leonardo Lopez, MD | |
|
1311 Memorial Dr Ste 500, Mendota, IL 61342-3013 | |
| (815) 539-3141 | |
| (815) 487-4901 |
| Full Name | Leonardo Lopez |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 29 Years |
| Location | 1311 Memorial Dr Ste 500, Mendota, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376643007 | NPI | - | NPPES |
| 036098968 | Other | IL | LICENSE |
| 336059388 | Other | IL | CONTROLLED SUB. LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036098968 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ottawa Regional Hospital Dba Osf Saint Elizabeth Mdl Ctr | Ottawa, IL | Hospital |
| Osf Saint Paul Medical Center | Mendota, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mendota Community Hospital | 2264335777 | 48 |
| Entity Name | Mendota Community Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407872997 PECOS PAC ID: 2264335777 Enrollment ID: O20040131000102 |
| Entity Name | Osf Multi-specialty Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
| Mailing Address | Practice Location Address |
|---|---|
| Leonardo Lopez, MD 1311 Memorial Dr Ste 500, Mendota, IL 61342-3013 Ph: (815) 539-3141 | Leonardo Lopez, MD 1311 Memorial Dr Ste 500, Mendota, IL 61342-3013 Ph: (815) 539-3141 |
Maritza Yesenia Estrada-o'brien, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 E 12th St Ste 600, Mendota, IL 61342 Phone: 815-538-7200 | |
Amy M Matheis-soliman, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 East 12th Street, Suite 600, Mendota, IL 61342 Phone: 815-538-7200 Fax: 815-539-1718 | |
David A Scholl, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1405 East 12th Street, Suite 600, Mendota, IL 61342 Phone: 815-538-7200 Fax: 815-539-1444 | |
Zachary J Fulton, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 E 12th St Ste 200, Mendota, IL 61342 Phone: 815-539-1710 |