OrganizationActive
Icc Treatment Center
NPI 1164388484 · Methadone Clinic · Chicago, IL
Icc Treatment Center is a Methadone Clinic organization in Chicago, IL (NPI 1164388484).
Provider details
- NPI number
- 1164388484
- Entity type
- Organization
- Primary specialty
- Methadone ClinicAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Marvin Coklow, Compliance Officer(773) 597-7698
Specialties & taxonomies
Ambulatory Health Care Facilities
Hospital Units
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1 E 111th Street
Chicago, IL 60628-9998
Phone: (773) 552-2769
Street-level locationGet directions
Mailing address
1 E 111th Street
Chicago, IL 60628-9998
Registry dates
- Enumerated
- 2025-12-30
- Last updated
- 2026-04-03
- Certified
- 2026-04-03
Frequently asked questions
- What is Icc Treatment Center's NPI number?
- Icc Treatment Center's National Provider Identifier (NPI) is 1164388484, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Icc Treatment Center?
- Icc Treatment Center is classified in the NPPES registry as Methadone Clinic (Ambulatory Health Care Facilities).
- Where is Icc Treatment Center located?
- Icc Treatment Center's practice location on file with NPPES is 1 E 111th Street, Chicago, IL 60628-9998.
- What is Icc Treatment Center's phone number?
- The practice phone number listed in the NPPES registry for Icc Treatment Center is (773) 552-2769.
- Who is the authorized official for Icc Treatment Center?
- The authorized official listed on Icc Treatment Center's NPPES record is Marvin Coklow, Compliance Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Icc Treatment Center's NPI active?
- Yes — Icc Treatment Center's NPI (1164388484) is active in the NPPES registry as of the last update on 2026-04-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.