Healthcare Provider Details

I. General information

NPI: 1487350815
Provider Name (Legal Business Name): ODA SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 10/07/2023
Certification Date: 10/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42371/2 WEST (5TH STREET
OAK LAWN IL
60453
US

IV. Provider business mailing address

42371/2 WEST (5TH STREET
OAK LAWN IL
60453
US

V. Phone/Fax

Practice location:
  • Phone: 708-529-3109
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL ROBINSON
Title or Position: PRESIDENT
Credential:
Phone: 708-856-7599