Organization
CHICAGO TREATMENT & COUNSELING CENTER #4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEMLATA VAIDYA (MEDICAL DIRECTOR)
(708) 652-6500
Entity
Organization
Contact information
Practice address
5635 W ROOSEVELT RD, CICERO, IL 60804-1230
(708) 652-6500
(708) 652-6475
Mailing address
5635 W ROOSEVELT RD, CICERO, IL 60804-1230
(708) 652-6500
(708) 652-6475
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
036069638
IL
261QM2800X
Methadone Clinic
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
Other
Enumeration date
05/08/2017
Last updated
02/25/2022
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