Healthcare Provider Details

I. General information

NPI: 1427976034
Provider Name (Legal Business Name): SPECIALIZED ASSISTANCE RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 N MAYFIELD AVE APT 2
CHICAGO IL
60651-3597
US

IV. Provider business mailing address

917 N MAYFIELD AVE
CHICAGO IL
60651-3597
US

V. Phone/Fax

Practice location:
  • Phone: 773-251-6815
  • Fax:
Mailing address:
  • Phone: 773-251-6815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. EUGENE D JACOBS
Title or Position: OWNER
Credential:
Phone: 773-251-6815