# STONYBROOK CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629374566
- **Authorized official:** CHARLES FRANCIS WALTER (OPERATIONS DIRECTOR)
- **Authorized official phone:** (630) 221-1400

## Contact information

- **Practice address:** 1506 E ROOSEVELT RD, WHEATON, IL 60187-6806
- **Practice address phone:** (630) 221-1400
- **Practice address fax:** (630) 221-1411
- **Mailing address:** 1506 E ROOSEVELT RD, WHEATON, IL 60187-6806
- **Mailing address phone:** (630) 221-1400
- **Mailing address fax:** (630) 221-1411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | A-8645-0001-A | IL | Yes |
| 261QM2800X | Methadone Clinic | — | NULL | — |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | A-8645-0002-A | IL | — |

## Other

- **Enumeration date:** 02/09/2011
- **Last updated:** 10/27/2017