Healthcare Provider Details

I. General information

NPI: 1154539435
Provider Name (Legal Business Name): COMPREHENSIVE MEDICAL MANAGEMENT SERVICES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1473 RING RD
CALUMET CITY IL
60409-5459
US

IV. Provider business mailing address

1473 RING RD
CALUMET CITY IL
60409-5459
US

V. Phone/Fax

Practice location:
  • Phone: 708-868-0003
  • Fax: 708-862-8105
Mailing address:
  • Phone: 708-868-0003
  • Fax: 708-862-8105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. ADEYEMI OLUDARE FATOKI
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 708-868-0003