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: July 19, 2026.

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

  • Individual
  • Female
  • Years of Experience 17
  • Counselor
  • Professional
  • May Accept Medicare Approved Payment
  • PECOS Enrolled

About THERESA KOPITZKE

This page provides the complete NPI Profile along with additional information for Theresa Kopitzke, a provider established in Evanston, Illinois with a medical specialization in Counselor, focusing in professional and more than 17 years of experience. The healthcare provider is registered in the NPI registry with number 1053280610 assigned on November 2025. The practitioner's primary taxonomy code is 101YP2500X with license number 180017559 (IL). The provider is registered as an individual and her NPI record was last updated February 2026.

NPI
1053280610 Verify this NPI
Provider Name
THERESA MARIE KOPITZKE LCPC
Gender
Female
Entity Type
Individual
Location Address
1000 CENTRAL ST STE 640 EVANSTON, IL 60201
Location Phone
(847) 869-0520
Mailing Address
2650 RIDGE AVE EVANSTON, IL 60201
Medical School Name
OTHER
Graduation Year
2010
Is Sole Proprietor?
Yes
Enumeration Date
11-03-2025
Last Update Date
02-03-2026
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Location Map

Secondary Locations

  • 4025 Lee St
    Skokie, IL 60076
    (773) 484-5601

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Counselor Professional

Taxonomy Code
101YP2500X
Type
Behavioral Health & Social Service Providers
License No.
180017559
License State
IL

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1101Y00000XBehavioral Health & Social Service Providers

Counselor

 

Medicare Participation & PECOS Enrollment Status

Theresa Kopitzke is registered with Medicare but may not accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Theresa Kopitzke is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4385123454

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20260216000288

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Maybe

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

Reviews for THERESA MARIE KOPITZKE LCPC

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Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Internal Medicine
1000 CENTRAL ST STE 640
EVANSTON, IL 60201
Internal Medicine
1000 CENTRAL ST STE 640
EVANSTON, IL 60201
Physician Assistant
1000 CENTRAL ST STE 640
EVANSTON, IL 60201
Pharmacist (Ambulatory Care)
1000 CENTRAL ST STE 640
EVANSTON, IL 60201
Nurse Practitioner
1000 CENTRAL ST STE 640
EVANSTON, IL 60201
Internal Medicine
1000 CENTRAL ST STE 640
EVANSTON, IL 60201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053280610, enumerated as an "individual" on November 03, 2025.

The provider is located at 1000 CENTRAL ST STE 640 EVANSTON, IL 60201 and the phone number is (847) 869-0520.

Counselor with taxonomy code 101YP2500X and a focus in Professional.