Individual
MR. EDWIN EDWARD KOPYTKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, RN, CNS
Contact information
Practice address
FIFTH AVENUE AND ROOSEVELT ROAD, HINES, IL 60141
(708) 202-8387
(708) 202-4572
Mailing address
8918 OXFORD ST, WOODRIDGE, IL 60517-4967
(708) 202-8387
(708) 202-4562
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
—
IL
Other
Enumeration date
08/02/2006
Last updated
07/08/2007
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