COPRO CLINICAL CONCEPTS, PC


Address: 4003 N Broadway St, Chicago, IL 60613-2110
Phone: 8475298607

COPRO CLINICAL CONCEPTS, PC (NPI# 1689981201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689981201
Entity Type Organization
Organization Name COPRO CLINICAL CONCEPTS, PC
Practice Address 4003 N Broadway St
Chicago
IL 60613-2110
Mailing Address 1755 E Carib Ln
Mount Prospect
IL 60056-1703
Practice Telephone 8475298607
Enumeration Date 2010-09-02
Last Update Date 2010-09-02
Authorized Official Name MR. COSTA D. PROVIS (PRESIDENT)
Authorized Official Telephone 8475298607
Authorized Official Credential L.C.P.C.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
Behavioral Health & Social Service Providers

Office Location

Street Address 4003 N BROADWAY ST
City CHICAGO
State IL
Zip Code 60613-2110

Providers in the same location

NPI Name Taxonomy Address Enumeration
1184602427 Vanessa Erica Ford Counselor 4003 N Broadway St, Suite 6, Chicago, IL 60613-2110 2006-01-06
1124385604 Adam Barrett Gray Social Worker 4003 N Broadway St, 2nd Floor, Chicago, IL 60613 2012-04-20
1306170154 Second Story Consultants Social Worker 4003 N Broadway St, Chicago, IL 60613-2110 2009-09-28
1689893299 Thomas J Stabnicki Social Worker 4003 N Broadway St, Chicago, IL 60613-2110 2007-04-24

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City CHICAGO
Zip Code 60613

Improve Information

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Dataset Information

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.

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