Healthcare Provider Details

I. General information

NPI: 1649174897
Provider Name (Legal Business Name): THE CHICAGO RECOVERY PROJECT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7331 S HONORE ST
CHICAGO IL
60636-3702
US

IV. Provider business mailing address

7331 S HONORE ST
CHICAGO IL
60636-3702
US

V. Phone/Fax

Practice location:
  • Phone: 612-207-9874
  • Fax:
Mailing address:
  • Phone: 612-207-9874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. LATRICIA SIMONE TATE
Title or Position: CEO
Credential: B.A
Phone: 612-207-9874