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NPI Code Detail

MEDICARE: CHICAGO TREATMENT AND COUNSELING CENTERS,INC

MEDICARE: CHICAGO TREATMENT AND COUNSELING CENTERS,INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM2800XMethadone Clinic036069638IL
2261QM2800XMethadone Clinic
3276400000XSubstance Use Disorder Rehabilitation Hospital Unit

General Provider Information

NPI Number : 1902228406
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHICAGO TREATMENT AND COUNSELING CENTERS,INC
Provider Business Mailing Address
First Line : 9350 CASCADE CIR
Second Line :
City : BURR RIDGE
State : IL
Zip : 60527-0712
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3520 S ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60609-1317
Country : US
Telephone Number : 312-399-5282
Fax Number :
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. HEMLATA P VAIDYA
Credential : M.D.
Telephone Number : 773-523-3400
Provider Enumeration Date : 01/17/2014
Last Update Date : 09/01/2021

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Directions to “CHICAGO TREATMENT AND COUNSELING CENTERS,INC ” Practice Location

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