NPIMap

Organization Active NPI

Chicago Treatment & Counseling Center #4

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cicero, IL
National Provider Identifier
1679009880
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CHICAGO TREATMENT & COUNSELING CENTER #4
Practice address
5635 W Roosevelt Rd
Cicero, IL 60804-1230
Phone
(708) 652-6500
Fax
(708) 652-6475
NPI assigned
May 8, 2017
Last updated
Feb 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Authorized official

Name
Hemlata Vaidya
Title
Medical Director
Phone
(708) 652-6500

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 036069638 IL
Methadone Clinic 261QM2800X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X

Addresses

Primary practice location

5635 W Roosevelt Rd
Cicero, IL 60804-1230

Mailing address

5635 W Roosevelt Rd
Cicero, IL 60804-1230
Phone (708) 652-6500

National Provider Directory

National Provider Directory
Tax ID family
Chicago Treatment and Counseling Centersinc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

5635 W Roosevelt Rd
Cicero, IL 60804
Phone (708) 652-6500

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1494201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1679009880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 W ROOSEVELT RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608041230",
            "telephone_number": "708-652-6500",
            "fax_number": "708-652-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 W ROOSEVELT RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608041230",
            "telephone_number": "708-652-6500",
            "fax_number": "708-652-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO TREATMENT & COUNSELING CENTER #4",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-08",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "VAIDYA",
        "authorized_official_first_name": "HEMLATA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "708-652-6500"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "036069638",
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.