Organization
SUNOVA HEALTHCARE S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE KOPACZ (PRACTICE MANAGAER)
(847) 559-5091
Entity
Organization
Contact information
Practice address
1420 RENAISSANCE DR STE 207, PARK RIDGE, IL 60068-1342
(847) 559-9015
(847) 574-7444
Mailing address
1480 RENAISSANCE DR STE 211, PARK RIDGE, IL 60068-1353
(847) 559-9015
(847) 296-6262
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036100094
IL
Other
Enumeration date
02/08/2016
Last updated
03/14/2023
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