MARYAM LOPEZ (APRN, CNP) – Nurse Practitioner, NPI 1154204006

MARYAM LOPEZ (APRN, CNP) is a healthcare provider. based in Orland park, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, CNP. They hold a License No. 209032068 (IL). The NPI Number for MARYAM LOPEZ (APRN, CNP) is 1154204006

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
MARYAM LOPEZ (APRN, CNP)
NPI
1154204006
Phone
(708) 226-2318
Address
15300 WEST AVE STE 100A
Enumeration Date
29 July 2025
Last Update Date
22 December 2025

Doctor Profile

Medical School Name
RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Secondary Phone
-
Graduation Year
2024 (2 years ago)
PAC ID
8527561091
Group Practice PAC ID
4587576814
Professional Enrollment ID
I20250911000744
Address ID
IL604624600OR15300AVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness85
Years active:0State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for MARYAM LOPEZ (APRN, CNP)

  • 15300 WEST AVE STE 100A

    ORLAND PARK, IL 604624600

    Phone: (708) 226-2318

    Fax: (708) 226-2319

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250911000744INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60462)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587576814View full group profile
NameSpecialtyState
-IL
Diagnostic Radiology, Interventional RadiologyIL
P A T H O L O G YIL
Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineIL
G A S T R O E N T E R O L O G YIL
Internal MedicineIL
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Internal MedicineMN
-IL
Physical Therapist In Private PracticeIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

What is the registry number for MARYAM LOPEZ (APRN, CNP)?
The registry entry for MARYAM LOPEZ (APRN, CNP) shows NPI 1154204006.
Quick check: is MARYAM LOPEZ (APRN, CNP) active?
Public NPPES data shows MARYAM LOPEZ (APRN, CNP) with an active NPI status right now.
Which specialty label fits MARYAM LOPEZ (APRN, CNP)?
NPPES ties MARYAM LOPEZ (APRN, CNP) to Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is MARYAM LOPEZ (APRN, CNP) tied to Orland Park, Illinois?
If you are local to Orland Park, Illinois, MARYAM LOPEZ (APRN, CNP) may be relevant to your search.
Why is information missing for MARYAM LOPEZ (APRN, CNP)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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