Provider Demographics
NPI:1750480281
Name:KOPALA, ROBERT (RDCS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:KOPALA
Suffix:
Gender:M
Credentials:RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 CHANCERY LN
Mailing Address - Street 2:
Mailing Address - City:CARPENTERSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60110-3467
Mailing Address - Country:US
Mailing Address - Phone:847-863-3280
Mailing Address - Fax:480-275-3199
Practice Address - Street 1:3512 CHANCERY LN
Practice Address - Street 2:
Practice Address - City:CARPENTERSVILLE
Practice Address - State:IL
Practice Address - Zip Code:60110-3467
Practice Address - Country:US
Practice Address - Phone:847-863-3280
Practice Address - Fax:480-275-3199
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography