NPIMap

Organization Active NPI

Community Counseling Centers of Chicago

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1487984498
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
04029 Issued in IL
Legal business name
COMMUNITY COUNSELING CENTERS OF CHICAGO
Practice address
4740 N Clark St
Chicago, IL 60640-4689
Phone
(773) 769-0205
Fax
(773) 765-0828
NPI assigned
Jan 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Authorized official

Name
Dr. Anthony A Kopera, PHD
Title
Ceo
Phone
(773) 765-0810

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 04029 IL Primary

Addresses

Primary practice location

4740 N Clark St
Chicago, IL 60640-4689

Mailing address

4740 N Clark St
Chicago, IL 60640-4689
Phone (773) 769-0205

Other identifiers 1

IdentifierTypeStateIssuer
04029MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Community Counseling Centers of Chicago21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1487984498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404689",
            "telephone_number": "773-769-0205",
            "fax_number": "773-765-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404689",
            "telephone_number": "773-769-0205",
            "fax_number": "773-765-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNSELING CENTERS OF CHICAGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "KOPERA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-765-0810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "04029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04029",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.