Healthcare Provider Details
I. General information
NPI: 1164397626
Provider Name (Legal Business Name): DUI GROUPS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15020 S RAVINIA AVE STE 21
ORLAND PARK IL
60462-5352
US
IV. Provider business mailing address
15020 S RAVINIA AVE STE 21
ORLAND PARK IL
60462-5352
US
V. Phone/Fax
- Phone: 708-710-0102
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 276400000X |
| Taxonomy | Substance Use Disorder Rehabilitation Hospital Unit |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MOHAMMED
TARAWNEH
Title or Position: OWNER
Credential:
Phone: 708-710-0102