Healthcare Provider Details

I. General information

NPI: 1427902469
Provider Name (Legal Business Name): FREEDOM INTERNATIONAL OUTREACH MINISTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S. CICERO AVE
CHICAGO IL
60644
US

IV. Provider business mailing address

PO BOX 223
PARK FOREST IL
60466-0223
US

V. Phone/Fax

Practice location:
  • Phone: 312-344-3396
  • Fax: 773-903-4782
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. COREY ROLLING
Title or Position: PROGRAM DIRECTOR
Credential: LSW
Phone: 773-746-2016