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ICC TREATMENT CENTER
NPI 1164388484
Clinic/Center - Methadone in Chicago, IL

Active since December 30, 2025
1 E 111TH STREET, CHICAGO, IL 60628(773) 552-2769 Get Directions Write a Review

NPPES record last updated: April 3, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 3, 2026, Mar 24, 2026, Dec 30, 2025 (3 updates tracked since 2025).

About Icc Treatment Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ICC TREATMENT CENTER (NPI 1164388484) is a healthcare organization registered as a methadone in Chicago, Illinois and active in the NPI registry since December 2025. The organization lists Marvin D Coklow, Compliance Officer, as its authorized official.

NPPES Registry Identity

NPI1164388484
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NameICC TREATMENT CENTER
Location Address1 E 111TH STREETChicago, IL 60628-9998
Mailing Address1 E 111th StreetChicago, IL 60628-9998 · (773) 552-2769
Phone(773) 552-2769
Organization SubpartNo
Authorized OfficialMarvin D CoklowCompliance Officer · (773) 597-7698
Enumeration DateDecember 30, 2025
Last NPPES UpdateApril 3, 20263 updates tracked since enumeration
NPPES CertifiedApril 3, 2026
✔ NPI 1164388484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
Definition

An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

Also ListedRehabilitation, Substance Use Disorder UnitTaxonomy 276400000X
1 E 111TH STREET, Chicago, IL 60628
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ICC TREATMENT CENTER
Clinic/Center (Adult Mental Health)
1 E 111TH STREET
CHICAGO, IL 60628
Cook County (773) 552-2769

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Icc Treatment Center's NPI number?

The NPI number for Icc Treatment Center is 1164388484. It was assigned to this organization in the NPPES registry on December 30, 2025.

Where is Icc Treatment Center located?

Icc Treatment Center is located at 1 E 111th Street, Chicago, IL 60628. The listed phone number is (773) 552-2769.

What is Icc Treatment Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

When was this NPI record last updated?

The NPPES record for Icc Treatment Center was last updated on April 3, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.