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General NPI Number Information
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NPI Number | 1265081624
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Entity Type | Organization
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Legal Business Name | OLATOYE REHABILITATION CENTERS, INC.
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 9135 S EXCHANGE AVE
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City | CHICAGO
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State | IL
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Zip | 60617-4225
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Country | US
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Telephone | 773-437-5444
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Fax | 773-437-5467
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Provider Business Mailing Address
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Address Line | 9135 S EXCHANGE AVE
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City | CHICAGO
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State | IL
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Zip | 60617-4225
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Country | US
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Telephone | 773-437-5444
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Fax |
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Authorized Official
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Title or Position | CCO
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Name | OLAFISAYO PEREZ
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Credential |
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Telephone | 773-437-5444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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