Healthcare Provider Details

I. General information

NPI: 1184787038
Provider Name (Legal Business Name): CAP OF DOWNERS GROVE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4954 MAIN ST
DOWNERS GROVE IL
60515-3611
US

IV. Provider business mailing address

4954 MAIN ST
DOWNERS GROVE IL
60515-3611
US

V. Phone/Fax

Practice location:
  • Phone: 630-810-0186
  • Fax: 630-810-0179
Mailing address:
  • Phone: 630-810-0186
  • Fax: 630-810-0179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License NumberA-3027-0001-A
License Number StateIL

VIII. Authorized Official

Name: DR. CRAIG V SHOWALTER
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 630-810-0186