Provider Demographics
NPI:1285692574
Name:DOPKE, CYNTHIA ANN (PHD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:DOPKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E ERIE ST
Mailing Address - Street 2:STE 601
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5934
Mailing Address - Country:US
Mailing Address - Phone:312-649-0854
Mailing Address - Fax:312-649-0882
Practice Address - Street 1:233 E ERIE ST
Practice Address - Street 2:601
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2926
Practice Address - Country:US
Practice Address - Phone:312-649-0854
Practice Address - Fax:312-649-0882
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-005926103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical