Healthcare Provider Details

I. General information

NPI: 1659187029
Provider Name (Legal Business Name): ARENA THERAPY AND JUSTICE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 MIDWEST RD STE 200
OAK BROOK IL
60523-1370
US

IV. Provider business mailing address

825 N CASS AVE STE 115
WESTMONT IL
60559-6401
US

V. Phone/Fax

Practice location:
  • Phone: 773-219-0702
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TATIANA DUCHAK
Title or Position: FOUNDER AND OWNER
Credential:
Phone: 703-589-3996