GREAT HEIGHTS OTP (NPI# 1881139418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881139418 |
Entity Type | Organization |
Organization Name | GREAT HEIGHTS OTP |
Other Organization Name | GREAT HEIGHTS FAMILY MEDICINE, OTTAWA NTP |
Practice Address |
315 E Mckinley Rd Ottawa IL 61350-4805 |
Practice Telephone | 8154340228 |
Mailing Telephone | 8154340228 |
Enumeration Date | 2017-01-06 |
Last Update Date | 2019-12-19 |
Authorized Official Name | ADEYEMI FATOKI (OWNER) |
Authorized Official Telephone | 3129529378 |
Authorized Official Credential | MD |
Is Organization Subpart | Y |
Parent Organization Name | GREAT HEIGHTS OTP |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | SUPR | A-6548-0002-A | 01 |
Other Name | Type Code |
---|---|
Great Heights Family Medicine, Ottawa NTP | Other Name - Individual/Organization |
Great Heights OTP Ottawa | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720516099 | Great Heights Otp | Clinic/Center | 1473 Ring Rd, Calumet City, IL 60409-5459 | 2017-05-31 |
1659816874 | Great Heights Otp | Clinic/Center | 1473 Ring Rd, Calumet City, IL 60409-5459 | 2016-12-23 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | GREAT HEIGHTS OTP., LLC | 315 E Mckinley Rd, Ottawa, IL 61350-4805 |
Street Address |
315 E MCKINLEY RD |
City | OTTAWA |
State | IL |
Zip Code | 61350-4805 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760449938 | Adeyemi Oludare Fatoki | Family Medicine | 315 E Mckinley Rd, Ottawa, IL 61350-4805 | 2006-04-28 |
1609303940 | Great Heights Medical Ltd. | Family Medicine | 315 E Mckinley Rd, Ottawa, IL 61350-4805 | 2017-05-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306336359 | Yulandist Jeannie Brown | Licensed Practical Nurse | 617 Columbus St, Ottawa, IL 61350 | 2018-05-15 |
1881071272 | Ashlee Herbold | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1718 N 2525th Rd, Ottawa, IL 61350 | 2015-05-05 |
1053702365 | Wanda Rohl | Social Worker | 3735 E 1453 Rd, Ottawa, IL 61350 | 2015-02-09 |
1538550868 | Erin Rose Boe | Physical Therapist | 2872 Columbus St, Unit 300, Ottawa, IL 61350 | 2015-02-09 |
1346572757 | Rebecca Samolitis | Counselor | 116 W Lafayette St, Suite 8, Ottawa, IL 61350 | 2010-02-10 |
1235383266 | Timothy I Miller O.d. P.C. | Optometrist | 107 E. Mckinley Rd., Ottawa, IL 61350 | 2008-11-04 |
1427204676 | Leo John Meagher | Counselor | 218 West Madison St, Ottawa, IL 61350 | 2008-08-07 |
1598938755 | Radiation Oncology of Northern Illinois LLC | Radiology | 1200 Starfire Dr, Ottawa, IL 61350 | 2008-04-09 |
1154538510 | Serenityonwheels, Inc. | Counselor | Serenity On Wheels, Inc. 630 Columbus Street, Ste # 214, Ottawa, IL 61350 | 2007-05-16 |
1205040904 | Dixie Devry | Occupational Therapist | 2532 Reynolds Manor, Ottawa, IL 61350 | 2007-05-10 |
Find all providers in zip 61350 |
Taxonomy Code | 261QM2800X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Methadone Clinic |
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245862457 | Jem Treatment, Inc | Clinic/Center | 2424 Washington St Ste Ll-110, Waukegan, IL 60085-5074 | 2020-02-05 |
1124659123 | Lake County Center, LLC | Clinic/Center | 310 S Greenleaf St Ste 206207, Gurnee, IL 60031-5708 | 2020-01-29 |
1750883286 | Buena Vista Group, LLC | Clinic/Center | 418 Dixie Hwy, Chicago Heights, IL 60411-1739 | 2018-02-28 |
1518485960 | The Bobby Buonauro Clinic | Clinic/Center | 1029 Howard St Ste 303, Evanston, IL 60202-3877 | 2017-09-06 |
1689196578 | Serenity Treatment and Counseling Center Inc | Clinic/Center | 19408 North Creek Drive, Lynwood, IL 60411-8649 | 2017-07-12 |
1699296129 | Loren 'half' Robinson Foundation | Clinic/Center | 4100 W Ogden Ave, Chicago, IL 60623-2821 | 2017-07-06 |
1942744453 | Recovery Concepts LLC | Clinic/Center | 17100 Dixie Hwy, Suite D & E, Hazel Crest, IL 60429-1485 | 2016-12-19 |
1184022303 | Renewed Hope Community Services Inc. | Clinic/Center | 626 E 71st St, Chicago, IL 60619-1212 | 2014-12-22 |
1316296007 | Sundance Methadone Treatment Center,llc | Clinic/Center | 4545 N Broadway St, 3rd Floor, Chicago, IL 60640-5975 | 2012-09-10 |
1790030344 | Ijegba Community Inc | Clinic/Center | 1950 E 75th St, Chicago, IL 60649-3633 | 2012-07-19 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.