David Kopacz, M.D.

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

DAVID KOPACZ, M.D.

Practice address

209 W University Ave
Suite 101
Champaign, IL 61820-3966

Phone

(217) 363-2891

Fax

(217) 359-0322

NPI assigned

Apr 8, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David Raymond Kopacz, M.D.NPI 1528013539

Title

Owner

Phone

(217) 363-2891

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Raymond Kopacz, M.D.

  • Psychiatry Physician
  • Champaign, IL
  • NPI 1528013539
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1245403542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W UNIVERSITY AVE",
            "address_2": "SUITE 101",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203966",
            "telephone_number": "217-363-2891",
            "fax_number": "217-359-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W UNIVERSITY AVE",
            "address_2": "SUITE 101",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203966",
            "telephone_number": "217-363-2891",
            "fax_number": "217-359-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID KOPACZ, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "KOPACZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-363-2891",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebonie Daugherty
• Shruti M Dave, M.D.
• Teresa L Davenport, PHD
• David H. Crowley and Associates LTD
• David J Fletcher MD LLC (Safe Works Illinois)
• Daniaja Shavon Davis-Chambers, LCSW
• Chalaine L Davis, BS LCWE
• Christopher Davis, RBT
• Jon Davis, MSW, LCSW
• Kayla Marie Davis

• Adult Mental Health Clinic/Center in Champaign, IL
• Providers in Champaign, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.