MEDICARE: DIVINE RECOVERY HOPE CLINIC INC. (DRHC)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM2800X	Methadone Clinic
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1457160541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE RECOVERY HOPE CLINIC INC. (DRHC)

Provider Business Mailing Address
First Line	:	3936 W ROOSEVELT RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624-4389
Country	:	US
Telephone Number	:	773-828-6900
Fax Number	:

Provider Business Practice Location Address
First Line	:	3936 W ROOSEVELT RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624-4389
Country	:	US
Telephone Number	:	773-828-6900
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TITILAYO OLADIPUPO
Credential	:	PHARMACIST
Telephone Number	:	708-407-0156

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	06/09/2026

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