Individual
BARBARA C KOPCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
630 E NORTH AVE, CAROL STREAM, IL 60188-2127
(630) 861-6663
Mailing address
630 E NORTH AVE, CAROL STREAM, IL 60188-2127
(630) 861-6663
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209003790
IL
363LG0600X
Gerontology Nurse Practitioner
209003790
IL
Other
Enumeration date
10/04/2005
Last updated
03/29/2021
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