Copro Clinical Concepts, PC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

COPRO CLINICAL CONCEPTS, PC

Practice address

4003 N Broadway St
Chicago, IL 60613-2110

Phone

(847) 529-8607

NPI assigned

Sep 2, 2010

Last updated

Sep 2, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Costa D. Provis, L.C.P.C.NPI 1679767826

Title

President

Phone

(847) 529-8607

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.

• Costa Provis, L.C.P.C.

  • Professional Counselor
  • Chicago, IL
  • NPI 1679767826
  Authorized official Same address or phone

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283385600000",
    "number": "1689981201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 E CARIB LN",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600561703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132110",
            "telephone_number": "847-529-8607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPRO CLINICAL CONCEPTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "PROVIS",
        "authorized_official_first_name": "COSTA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-529-8607",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.C.P.C."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott H Coppel, MD
• Casey Dean Coppess
• Allyson Nan Coppin, L.C.S.W.
• Rachel Coppinger, PHARMD
• Marissa Ann Coppola
• Cristin Coquillard
• Michelle Marie Cora Soto, MD
• Yamilca Cora-Fernandez
• Dashae A Cora
• Coral Heart Counseling, LLC

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.