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
4007 N BROADWAY ST, CHICAGO, IL 60613-2110
(773) 305-1101
(773) 305-1107
Mailing address
4740 N CLARK ST, CHICAGO, IL 60640-4689
(773) 769-0205
(773) 765-0801
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
04029
IL
Other
Enumeration date
03/16/2007
Last updated
04/20/2008
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