Individual
KIMBERLY KOPKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
345 E SUPERIOR ST, CHICAGO, IL 60611-2654
(312) 238-1000
Mailing address
861 W CORNELIA AVE APT 1, CHICAGO, IL 60657-6900
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056009194
IL
Other
Enumeration date
10/18/2010
Last updated
10/18/2010
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