Organization
COMMUNITY COUNSELING CENTERS OF CHICAGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY A KOPERA PHD (PRESIDENT & C.E.O.)
(773) 769-0205
Entity
Organization
Contact information
Practice address
2525 W PETERSON AVE, CHICAGO, IL 60659-4108
(773) 506-2525
(773) 765-0622
Mailing address
4740 N CLARK ST, CHICAGO, IL 60640-4689
(773) 769-0205
(773) 765-0801
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
04029
IL
Other
Enumeration date
03/16/2007
Last updated
04/20/2008
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