Organization
ROSEATE DAWN NEW BEGINNINGS INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN D COKLOW (COMPLIANCE OFFICER)
(773) 597-7698
Entity
Organization
Contact information
Practice address
4126 WEST 87TH STREET, HOMETOWN, IL 60456
(312) 498-7177
(773) 498-7177
Mailing address
5030 N MARINE DR APT 806, CHICAGO, IL 60640-3372
(773) 597-7698
(773) 597-7698
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
12/12/2025
Last updated
12/12/2025
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