COMMUNITY COUNSELING CENTERS OF CHICAGO (NPI# 1487778536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487778536 |
| Entity Type | Organization |
| Organization Name | COMMUNITY COUNSELING CENTERS OF CHICAGO |
| Practice Address |
11740 S Western Ave Chicago IL 60643-4732 |
| Mailing Address |
4740 N Clark St Chicago IL 60640-4689 |
| Practice Telephone | 7733712700 |
| Practice Fax Number | 7732397933 |
| Mailing Telephone | 7737690205 |
| Mailing Fax Number | 7737650801 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | DR. ANTHONY A KOPERA (PRESIDENT & C.E.O.) |
| 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 |
| 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 |
| 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 |
| 1487984498 | Community Counseling Centers of Chicago | Clinic/Center | 4740 N Clark St, Chicago, IL 60640-4689 | 2010-01-14 |
| Street Address |
11740 S WESTERN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60643-4732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356955744 | Solutions Counseling and Consulting Group | Rehabilitation, Substance Use Disorder Unit | 11740 S Western Ave, Chicago, IL 60643-4732 | 2020-09-02 |
| 1477172914 | Richard Randolph | Counselor | 11740 S Western Ave, Chicago, IL 60643-4732 | 2020-04-14 |
| 1114552486 | Jasmine Kayla Johnson | Counselor | 11740 S Western Ave, Chicago, IL 60643-4732 | 2020-03-07 |
| 1245528710 | Beacon Therapeutic School, Inc. | Clinic/Center | 11740 S Western Ave, Chicago, IL 60643-4732 | 2011-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154941698 | Breann Hampton | Behavior Technician | 1214 W 115th St, Chicago, IL 60643 | 2020-04-24 |
| 1366075566 | Sanctuary Counseling, LLC | Home Health | 12247 S Racine Ave, Calumet Park, IL 60643 | 2020-02-16 |
| 1467082883 | Juliana Frances Cunningham | Developmental Therapist | 10037 S Bell, Chicago, IL 60643 | 2020-01-24 |
| 1013578624 | Sct Counseling | Counselor | 11948 S Western Ave, Chicago, IL 60643 | 2019-06-25 |
| 1073087474 | For Eyes Optical Company of Pa | Optometrist | 9900 S Ridgleland Ave, Chicago Ridge, IL 60643 | 2019-01-18 |
| 1073096426 | Derek Peake | Physical Therapist | 9465 S. Western Road, Chicago, IL 60643 | 2018-09-12 |
| 1508356072 | Halo Medical Professionals Sc. | Chiropractor | 10650 S Western Ave, Chicago, IL 60643 | 2018-05-10 |
| 1811405699 | Kara Eileen Noland | Developmental Therapist | 9327 S Hamilton Ave, Chicago, IL 60643 | 2018-01-16 |
| 1588173546 | Kiah Nicole Bouie | Behavioral Analyst | 1461 W 113th Pl, Chicago, IL 60643 | 2017-09-21 |
| 1174042766 | Travis Wade Robertson | Physical Therapist | 10909-11 S Western Ave, Beverly, IL 60643 | 2017-09-14 |
| Find all providers in zip 60643 | ||||
| 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.