Basic Information
Provider Information
NPI: 1891746954
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOPATKA
FirstName: JULIE
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherLastNameType:  
Mailing Information
Address1: 4201 WINFIELD RD FL 4
Address2:  
City: WARRENVILLE
State: IL
PostalCode: 605554025
CountryCode: US
TelephoneNumber: 3312216377
FaxNumber: 3312212357
Practice Location
Address1: 1200 S YORK ST STE 2000
Address2:  
City: ELMHURST
State: IL
PostalCode: 601265634
CountryCode: US
TelephoneNumber: 3312219002
FaxNumber: 3312212747
Other Information
ProviderEnumerationDate: 05/13/2006
LastUpdateDate: 05/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X036108721ILY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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