NPIMap

Organization Active NPI

Proviso-Leyden Council for Community Action Inc

  • Methadone Clinic
  • Maywood, IL
National Provider Identifier
1386589034
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
PROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC
Practice address
308 S 5TH Ave
Maywood, IL 60153-1650
Phone
(708) 343-1275
NPI assigned
Apr 21, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Claudette Harrell
Title
Ceo
Phone
(708) 450-3500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Methadone Clinic 261QM2800X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

308 S 5TH Ave
Maywood, IL 60153-1650

Mailing address

411 Madison St
Maywood, IL 60153-2136
Phone (708) 450-3500

National Provider Directory

National Provider Directory
Tax ID family
Proviso-Leyden Council9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

411 Madison St
Maywood, IL 60153
Phone (708) 236-5042

NPI Registry JSON

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

{
    "created_epoch": "1776729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1386589034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 MADISON ST",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601532136",
            "telephone_number": "708-450-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 S 5TH AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601531650",
            "telephone_number": "708-343-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "CLAUDETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-450-3500"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.