Organization
CTF ILLINOIS
Active
Organization
CTF ILLINOIS
Active
Other names
CTF ACCESS-SUPR
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI L CODY (EXECUTIVE ASSISTANT)
(708) 429-1260
Entity
Organization
Contact information
Practice address
530 E 162ND ST, SOUTH HOLLAND, IL 60473-2326
(708) 429-1260
(708) 429-9170
Mailing address
18230 ORLAND PKWY, ORLAND PARK, IL 60467-5688
(708) 429-1260
(708) 429-9107
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
11/04/2021
Last updated
01/12/2022
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