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General NPI Number Information
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NPI Number | 1851825392
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Entity Type | Individual
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Provider Name | ALEXIA COPENHAVER M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1200 HARGER RD STE 200
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City | OAK BROOK
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State | IL
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Zip | 60523-1816
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Country | US
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Telephone | 630-607-0387
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Fax |
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Provider Business Mailing Address
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Address Line | 111 W WACKER DR APT 4812
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City | CHICAGO
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State | IL
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Zip | 60601-1691
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Country | US
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Telephone | 303-396-8125
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 150963
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License Number State | IL
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