Provider Demographics
NPI:1699246629
Name:APRIL KOPP LCSW PLLC
Entity type:Organization
Organization Name:APRIL KOPP LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPP
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-620-0354
Mailing Address - Street 1:3720 N KEDVALE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-3127
Mailing Address - Country:US
Mailing Address - Phone:708-620-0354
Mailing Address - Fax:
Practice Address - Street 1:4707 N BROADWAY ST STE 200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-4999
Practice Address - Country:US
Practice Address - Phone:708-620-0354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1073883294Medicaid