Healthcare Provider Details

I. General information

NPI: 1811806490
Provider Name (Legal Business Name): TOMI COMMUNITY RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4246 W LAKE ST
CHICAGO IL
60624-1722
US

IV. Provider business mailing address

18300 S HALSTED ST STE B
GLENWOOD IL
60425-1051
US

V. Phone/Fax

Practice location:
  • Phone: 708-593-1997
  • Fax:
Mailing address:
  • Phone: 708-593-1997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ERICKA STUCKEY
Title or Position: FOUNDER & PROGRAM DIRECTOR
Credential: CADC, QMHP
Phone: 708-593-1997