Organization
DAVID KOPACZ, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID RAYMOND KOPACZ M.D. (OWNER)
(217) 363-2891
Entity
Organization
Contact information
Practice address
209 W UNIVERSITY AVE, SUITE 101, CHAMPAIGN, IL 61820-3966
(217) 363-2891
(217) 359-0322
Mailing address
209 W UNIVERSITY AVE, SUITE 101, CHAMPAIGN, IL 61820-3966
(217) 363-2891
(217) 359-0322
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
IL
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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