Provider Demographics
NPI:1386913135
Name:D.A. JOPP & ASSOCIATES
Entity type:Organization
Organization Name:D.A. JOPP & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JOPP
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:224-355-3112
Mailing Address - Street 1:PO BOX 613
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-0613
Mailing Address - Country:US
Mailing Address - Phone:815-521-1889
Mailing Address - Fax:815-521-1889
Practice Address - Street 1:1300 W BELMONT AVE
Practice Address - Street 2:SUITE 504
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3200
Practice Address - Country:US
Practice Address - Phone:224-355-3112
Practice Address - Fax:815-521-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006401103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty