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THERESA MARIE KOPITZKE LCPC
NPI 1053280610
Counselor - Professional in Evanston, IL

Active since November 03, 2025PECOS Enrolled
1000 CENTRAL ST STE 640, EVANSTON, IL 60201(847) 869-0520 Get Directions Write a Review

NPPES record last updated: February 3, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Feb 3, 2026, Jan 28, 2026, Nov 3, 2025 (3 updates tracked since 2025).

About Theresa Marie Kopitzke Lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THERESA MARIE KOPITZKE LCPC (NPI 1053280610) is an individual professional provider in Evanston, Illinois, licensed in Illinois (180017559) and active in the NPI registry since November 2025. She is enrolled in Medicare PECOS, maintains a secondary practice location in Skokie, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1053280610
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameTHERESA MARIE KOPITZKECredential: LCPC
Location Address1000 CENTRAL ST STE 640Evanston, IL 60201-1780
Mailing Address2650 Ridge AveEvanston, IL 60201-1700
Phone(847) 869-0520
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateNovember 3, 2025
Last NPPES UpdateFebruary 3, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2026
✔ NPI 1053280610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 180017559
Also ListedCounselorTaxonomy 101Y00000X
1000 CENTRAL ST STE 640, Evanston, IL 60201
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Secondary Practice Location 1

Location 14025 Lee StSkokie, IL 60076-2137 · Phone (773) 484-5601

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theresa Marie Kopitzke Lcpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4385123454
PECOS Enrollment IDI20260216000288
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ZAINAB QUADRI MD
Internal Medicine
1000 CENTRAL ST STE 640
EVANSTON, IL 60201
Cook County (847) 570-1410
EMILY N. WOO
Internal Medicine
1000 CENTRAL ST STE 640
EVANSTON, IL 60201
Cook County (847) 570-1410
MICHAEL LA PA-C
Physician Assistant
1000 CENTRAL ST STE 640
EVANSTON, IL 60201
Cook County (847) 982-6710
DR. MINA LEE RYU M.D.
Internal Medicine
1000 CENTRAL ST STE 640
EVANSTON, IL 60201
Cook County (847) 570-1410
DR. MATTHEW BISZEWSKI PHARM.D.
Pharmacist (Ambulatory Care)
1000 CENTRAL ST STE 640
EVANSTON, IL 60201
Cook County (331) 221-0060
RIJADA LELIC AGNP-C
Nurse Practitioner
1000 CENTRAL ST STE 640
EVANSTON, IL 60201
Cook County (847) 570-1410

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Kopitzke's NPI number?

The NPI number for Theresa Kopitzke is 1053280610. It was assigned to this individual provider in the NPPES registry on November 3, 2025.

Where is Theresa Kopitzke located?

Theresa Kopitzke practices at 1000 Central St Ste 640, Evanston, IL 60201. The listed phone number is (847) 869-0520.

What is Theresa Kopitzke's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Theresa Kopitzke enrolled in Medicare?

Yes. Theresa Kopitzke is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Theresa Kopitzke was last updated on February 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.