COMMUNITY COUNSELING CENTERS OF CHICAGO (NPI# 1083634901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083634901 |
| Entity Type | Organization |
| Organization Name | COMMUNITY COUNSELING CENTERS OF CHICAGO |
| Practice Address |
4740 N Clark St Chicago IL 60640-4689 |
| Mailing Address |
4740 N. Clark St. Chicago IL 60640 |
| Practice Telephone | 7737690205 |
| Practice Fax Number | 7737650801 |
| Mailing Telephone | 7737690205 |
| Mailing Fax Number | 7737650801 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | DR. ANTHONY A KOPERA (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7737690205 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
04029 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 1616824 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225152796 | Community Counseling Centers of Chicago | Clinic/Center | 1029 S May St, Chicago, IL 60607-4232 | 2007-03-19 |
| 1740304229 | Community Counseling Centers of Chicago | Clinic/Center | 4604 N Beacon St, Chicago, IL 60640-4605 | 2007-03-19 |
| 1194849604 | Community Counseling Centers of Chicago | Clinic/Center | 5710 N Winthrop Ave, Chicago, IL 60660-4335 | 2007-03-19 |
| 1487778536 | Community Counseling Centers of Chicago | Clinic/Center | 11740 S Western Ave, Chicago, IL 60643-4732 | 2007-03-16 |
| 1952418469 | Community Counseling Centers of Chicago | Clinic/Center | 2545 W North Ave, Chicago, IL 60647-5296 | 2006-08-23 |
| 1114393691 | Community Counseling Centers of Chicago | Community/Behavioral Health | 2542 W North Ave, Chicago, IL 60647-5216 | 2015-08-19 |
| 1548608482 | Community Counseling Centers of Chicago | Community/Behavioral Health | 1123 Emerson St, Evanston, IL 60201-3100 | 2013-06-13 |
| 1376841262 | Community Counseling Centers of Chicago | Community/Behavioral Health | 2525 W Peterson Ave, Chicago, IL 60659-4108 | 2011-03-02 |
| 1841520855 | Community Counseling Centers of Chicago | Clinic/Center | 4740 N Clark St, Chicago, IL 60640-4689 | 2010-01-14 |
| 1013247022 | Community Counseling Centers of Chicago | Clinic/Center | 4740 N Clark St, Chicago, IL 60640-4689 | 2010-01-14 |
| Street Address |
4740 N CLARK ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640-4689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861411357 | Todd Frederick Harrison | Social Worker | 4740 N Clark St, C/o C4, Chicago, IL 60640-4689 | 2006-07-18 |
| 1972141950 | Alison Dowd | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2019-12-20 |
| 1275007486 | Teri Cicurel | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2019-01-22 |
| 1609346410 | Chantal Pico | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2018-12-05 |
| 1023595683 | Michelle L Johnson | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2018-07-25 |
| 1649770827 | Judith D Russell | Registered Nurse | 4740 N Clark St, Chicago, IL 60640-4689 | 2018-02-14 |
| 1871009167 | Andrea Vernon-cwik | Social Worker | 4740 N Clark St, Chicago, IL 60640-4689 | 2017-12-21 |
| 1790290385 | Anna Lyman | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2017-12-05 |
| 1639540974 | John Vizuete | Social Worker | 4740 N Clark St, Chicago, IL 60640-4689 | 2015-10-13 |
| 1063888618 | Monica Sade Mitchell | Counselor | 4740 N Clark St, Chicago, IL 60640-4689 | 2015-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
| Find all providers in zip 60640 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
| 1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| 1144837055 | Totality. Therapies LLC | Clinic/Center | 2027 W Division St Ste 157, Chicago, IL 60622-9024 | 2020-09-24 |
| 1790391373 | Luminary Solutions, LLC | Clinic/Center | 3166 N Lincoln Ave Ste 305, Chicago, IL 60657-3119 | 2020-09-19 |
| 1114533924 | A Safe Haven, L.L.C. | Clinic/Center | 600 S Wabash Ave, Chicago, IL 60605-1808 | 2020-09-17 |
| 1235745142 | A Safe Haven, L.L.C. | Clinic/Center | 7355 N Damen Ave, Chicago, IL 60645-2311 | 2020-09-17 |
| 1386250199 | A Safe Haven, L.L.C. | Clinic/Center | 7342-46 S Kingston, Chicago, IL 60649 | 2020-09-17 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.