EBONY R COPELAND (NPI# 1548404031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548404031 |
| Entity Type | Individual |
| Full Name | EBONY R COPELAND |
| Credential | M.D. |
| Practice Address |
836 W Wellington Ave Chicago IL 60657-5147 |
| Mailing Address |
85 W Burnside Ave Bronx NY 10453-4015 |
| Practice Telephone | 7732968250 |
| Mailing Telephone | 7184831270 |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2014-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0000X |
Family Medicine Specialization: Adolescent Medicine |
275661 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
836 W WELLINGTON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60657-5147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073596904 | William Norman Werner | Internal Medicine | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2005-11-23 |
| 1124629605 | Haroon Ali | Student in an Organized Health Care Education/Training Program | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-11-03 |
| 1700491032 | Ahmed Mostafa | Surgery | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-09-14 |
| 1598379604 | Natalie Merrick | Social Worker | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-09-04 |
| 1184235392 | Pooja Singh | Internal Medicine | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-08-11 |
| 1528677135 | Oubada Alkowatli | Student in an Organized Health Care Education/Training Program | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-07-29 |
| 1841809571 | Saumya Agrawal | Student in an Organized Health Care Education/Training Program | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-07-29 |
| 1376152900 | Abdelgalil Mukhtar | Student in an Organized Health Care Education/Training Program | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-07-29 |
| 1962010603 | Jamie Berray | Dietitian, Registered | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-07-20 |
| 1942818620 | Ali Doruk Yalcintepe | Student in an Organized Health Care Education/Training Program | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303887 | Simone Paes | Behavior Technician | 3141 N Sheffield Ave, Chicago, IL 60657 | 2020-10-13 |
| 1821613175 | Samridhi Khatri | Internal Medicine | 836 W. Wellington Ave, Advocate Illinois Masonic Medica, Suite 1312, Chigaco, IL 60657 | 2020-06-12 |
| 1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
| 1790304657 | Mehr Amer Mjeed | Student in an Organized Health Care Education/Training Program | Advocate Internal Medicine Clinic, Advocate Illinois Ma, 836 West Wellington Avenue, Chicago, IL 60657 | 2020-04-10 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1306493408 | Art of Sight Eyecare, LLC | Optometrist | 2915 N. Broadway, Chicago, IL 60657 | 2019-08-22 |
| 1992359277 | Joseph Michael Rochford IIi | Counselor | 1358 W Belmont Ave, Unit # 202, Chicago, IL 60657 | 2019-07-25 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1003388810 | Evolve Wellness S.c. | Counselor | 2845 North Sheridan Road, Suite 708, Chicago, IL 60657 | 2018-12-19 |
| 1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
| Find all providers in zip 60657 | ||||
| Taxonomy Code | 207QA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adolescent Medicine |
| A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023517331 | Chicago Medical Healthcare Group, S.c. | Family Medicine | 3648 W Armitage Avenue, Chicago, IL 60647 | 2018-02-02 |
| 1548492234 | 63rd Advanced Health Clinic Inc | Family Medicine | 1249 W 63rd St, Chicago, IL 60636-1947 | 2009-08-14 |
| 1518969518 | Ghousia Begum Ali | Family Medicine | 2136 W Devon Ave, Chicago, IL 60659-2127 | 2005-08-10 |
| 1568099380 | Bianca Jenkins | Family Medicine | 251 E Huron St, Chicago, IL 60611-2908 | 2020-03-23 |
| 1740779024 | Karen Batty | Family Medicine | 3000 S King Dr, Chicago, IL 60616-3452 | 2018-05-02 |
| 1558593947 | Kedzie Medical Clinic Inc | Family Medicine | 262 N Kedzie Ave, Chicago, IL 60612-1869 | 2009-08-18 |
| 1629204961 | Sarah Jahns Kidder | Family Medicine | 800 E 55th St, Chicago, IL 60615 | 2009-06-01 |
| 1386770642 | Rosa Subero | Family Medicine | 3600 W Fullerton Ave, Chicago, IL 60647-2319 | 2007-02-23 |
| 1649325929 | Nela Rodriguez Cordero | Family Medicine | 2002 N Damen Ave, Chicago, IL 60647-4527 | 2007-01-24 |
| 1992811178 | Trv - Family Medicine, Ltd. | Family Medicine | 2740 W Foster Ave, Suite 214, Chicago, IL 60625-3500 | 2006-08-21 |
| Find all providers in CHICAGO | ||||
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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.