DAVID KOPACZ, M.D. (NPI# 1245403542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245403542 |
| Entity Type | Organization |
| Organization Name | DAVID KOPACZ, M.D. |
| Practice Address |
209 W University Ave Suite 101 Champaign IL 61820-3966 |
| Practice Telephone | 2173632891 |
| Practice Fax Number | 2173590322 |
| Mailing Telephone | 2173632891 |
| Mailing Fax Number | 2173590322 |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |
| Authorized Official Name | DR. DAVID RAYMOND KOPACZ (OWNER) |
| Authorized Official Telephone | 2173632891 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
IL | Ambulatory Health Care Facilities |
| Street Address |
209 W UNIVERSITY AVE SUITE 101 |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61820-3966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043496425 | Lindsey Joy Francke | Counselor | 209 W University Ave, Apt 4, Champaign, IL 61820-3966 | 2008-01-15 |
| 1093020059 | Michelle Annette Morneau | Massage Therapist | 209 W University Ave, Champaign, IL 61820-3966 | 2010-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1255963583 | Jamey Richard Bailey | Social Worker | 701 Devonshire Drive, Bldg C, Suite 206, C-6, Champaign, IL 61820 | 2020-02-05 |
| 1790247443 | Jason Abrams | Counselor | 201 W Springfield Ave., Suite 1002-1003, Champaign, IL 61820 | 2019-04-02 |
| 1184100273 | Janine Rafferty | Pharmacist | 2002 N Neil St, Champaign, IL 61820 | 2018-07-12 |
| 1417475070 | Brodbeck Counseling, PC | Community/Behavioral Health | 301 N. Neil Street Suite 323, Champaign, IL 61820 | 2017-09-05 |
| 1447773726 | Quanata M Pelmore | Nurse's Aide | 508 E. Vine St, Champaign, IL 61820 | 2017-07-19 |
| 1821518127 | Molly Mclay | Social Worker | 309 W Clark St., Champaign, IL 61820 | 2017-06-27 |
| 1396265849 | Lou Echols Chambers | Audiologist | 901 South Sixth Street, Chamapign, IL 61820 | 2017-06-26 |
| 1962874495 | Luciana Angelica Guardini | Social Worker | 100 North Chestnut Street, Suite 244, Champaign, IL 61820 | 2015-10-23 |
| 1538544465 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 410 E University Ave Ste 105, Champaign, IL 61820 | 2015-07-21 |
| Find all providers in zip 61820 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457846594 | Wilma L. Bryant Psychotherapy Ltd | Clinic/Center | 100 N Chestnut St Ste 229, Champaign, IL 61820-4856 | 2018-06-29 |
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|---|---|---|---|---|
| 1245831569 | Chicago Psychiatric LLC | Clinic/Center | 800 W Cornelia Ave Apt 303, Chicago, IL 60657-2086 | 2020-11-03 |
| 1184223133 | Kevin P. Mcdunn, Psyd, LLC | Clinic/Center | 605 W Madison St Apt 2001, Chicago, IL 60661-2469 | 2020-10-21 |
| 1699372250 | Ctf Illinois | Clinic/Center | 1400 Reynolds Dr, Charleston, IL 61920-2411 | 2020-10-07 |
| 1124634852 | Prosper Counseling Services | Clinic/Center | 808 W Junior Ter Apt 303, Chicago, IL 60613-1657 | 2020-09-17 |
| 1962017665 | Hopeology, Pllc | Clinic/Center | 700 E North St Ste B, Elburn, IL 60119-7009 | 2020-09-10 |
| 1013521301 | Self Connected Therapy LLC | Clinic/Center | 2189 N. Rt. 83, #292, Round Lake Beach, IL 60073 | 2020-09-03 |
| 1508479288 | Bash Psychotherapy Corporation | Clinic/Center | 413 E Berry Rd, Barrington, IL 60010-3317 | 2020-08-24 |
| 1326658402 | Ventura Counseling, LLC | Clinic/Center | 620 Manchester Ave, Westchester, IL 60154-2714 | 2020-08-04 |
| 1265040760 | Orchid Counseling Chicago | Clinic/Center | 451 W Melrose St Apt 610, Chicago, IL 60657-3826 | 2020-07-21 |
| 1164040630 | Sunshine Therapy Pllc | Clinic/Center | 3328 N Bell Ave, Chicago, IL 60618-6204 | 2020-07-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.