Provider Demographics
NPI:1760921134
Name:HIPPENSTEEL, JACOB, & KOPPE THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:HIPPENSTEEL, JACOB, & KOPPE THERAPY SERVICES LLC
Other - Org Name:HJK THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPPE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-778-5117
Mailing Address - Street 1:8125 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3213
Mailing Address - Country:US
Mailing Address - Phone:312-778-5116
Mailing Address - Fax:312-778-5254
Practice Address - Street 1:1740 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-5918
Practice Address - Country:US
Practice Address - Phone:312-778-5115
Practice Address - Fax:312-778-5256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-18
Last Update Date:2017-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009167101YP2500X
IL1490111931041C0700X
IL1490109251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty