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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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