NPIMap

Organization Active NPI

Pdssc-Chicago, Inc.

  • Methadone Clinic
  • Chicago, IL
National Provider Identifier
1316151871
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
A-3407-0001-A Issued in IL
Legal business name
PDSSC-CHICAGO, INC.
Practice address
2260 N Elston Ave
Chicago, IL 60614
Phone
(773) 772-2450
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kenneth P Davis, MD, PH.DNPI 1205040771
Title
President
Phone
(773) 772-2450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X A-3407-0001-A IL Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-3407-0001-A IL

Addresses

Primary practice location

2260 N Elston Ave
Chicago, IL 60614

Mailing address

2260 N Elston Ave
Chicago, IL 60614-2930
Phone (773) 772-2450

Other names 1

  • Professional Diagnostic Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Opioid treatment program
Medicare-enrolled since Jan 8, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200415000020 IL Part B Supplier - Opioid Treatment Program (Otp) 6800226804 Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

2260 N Elston Ave
Chicago, IL 60614
Phone (773) 772-2450

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1316151871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142930",
            "telephone_number": "773-772-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "773-772-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDSSC-CHICAGO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-772-2450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PH.D"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "IL",
            "license": "A-3407-0001-A",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-3407-0001-A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Diagnostic Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Professional Diagnostic Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.