Healthcare Provider Details

I. General information

NPI: 1528992385
Provider Name (Legal Business Name): CTF ILLINOIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18230 ORLAND PARKWAY
ORLAND PARK IL
60467-5688
US

IV. Provider business mailing address

18230 ORLAND PKWY
ORLAND PARK IL
60467-5688
US

V. Phone/Fax

Practice location:
  • Phone: 708-429-1260
  • Fax: 708-429-9107
Mailing address:
  • Phone: 708-429-1260
  • Fax: 708-429-9107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KELLI L CODY
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 708-429-1260