Organization
IJEGBA COMMUNITY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLUFUNMILAYO KALE (PROGRAM DIRECTOR)
(773) 684-8422
Entity
Organization
Contact information
Practice address
1950 E 75TH ST, CHICAGO, IL 60649-3633
(773) 684-8422
Mailing address
1950 E 75TH ST, CHICAGO, IL 60649-3633
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/19/2012
Last updated
10/26/2016
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