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Organization
GREAT HEIGHTS OTP
Active
Organization
GREAT HEIGHTS OTP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADEYEMI FATOKI MD (MEDICAL DIRECTOR)
(708) 862-8156
Entity
Organization
Contact information
Practice address
1473 RING RD, CALUMET CITY, IL 60409-5459
(708) 862-8156
Mailing address
1473 RING RD, CALUMET CITY, IL 60409-5459
(708) 862-8156
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
05/31/2017
Last updated
12/19/2019
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