Organization
PROVISO PUBLIC PARTNERSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE WILLIAMS (FINANCIAL OFFICER)
(708) 234-8661
Entity
Organization
Contact information
Practice address
2619 CONGRESS ST, BELLWOOD, IL 60104-2405
(708) 240-4435
Mailing address
4565 HARRISON ST FL 3, HILLSIDE, IL 60162-1617
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/27/2026
Last updated
01/27/2026
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