Icc Treatment Center

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

ICC TREATMENT CENTER

Practice address

1 E 111TH Street
Chicago, IL 60628-9998

Phone

(773) 552-2769

NPI assigned

Dec 30, 2025

Last updated

Apr 3, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Marvin D CoklowNPI 1710612478

Title

Compliance Officer

Phone

(773) 597-7698

Specialties & licenses 1

Addresses

Tax ID family

Icc Treatment Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Icc Treatment Center

  • Methadone Clinic
  • Chicago, IL
  • NPI 1164388484
  NPD tax ID

Locations

Practitioners 1

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.

• Marvin Coklow

  • Point of Service
  • Chicago, IL
  • NPI 1710612478
  Authorized official Same address or phone

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

{
    "created_epoch": "1767052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775174400000",
    "number": "1699631929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E 111TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606289998",
            "telephone_number": "773-552-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E 111TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606289998",
            "telephone_number": "773-552-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICC TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-30",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A",
        "authorized_official_last_name": "COKLOW",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "773-597-7698",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ibukun Comprehensive Community Services, Inc.
• Kathryn Claire Ibur, LCSW
• Icare Home Health Corporation (iCARE Home Health)
• Icare Optical, LLC
• Icc Treatment Center
• Icg Home Health Care
• Icg Services, LLC (Spectrum of Smiles)
• Vicken Ichkhan, D.D.S.
• Ico Dental, LLC
• Icon Events Co

• Adult Mental Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.