OrganizationActive
Sundance Methadone Treatment Center,llc
NPI 1316296007 · Methadone Clinic · Chicago, IL
Provider details
- NPI number
- 1316296007
- Entity type
- Organization
- Primary specialty
- Methadone ClinicAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tony Woodard, Program Director(773) 769-4545
- License
- A31350001 (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Hospital Units
Residential Treatment Facilities
Practice location
4545 N Broadway St
3rd Floor
Chicago, IL 60640-5975
Phone: (773) 784-1111
Fax: (773) 784-4910
Approximate (ZIP-level) locationGet directions
Mailing address
4545 N Broadway St
Chicago, IL 60640-5975
Registry dates
- Enumerated
- 2012-09-10
- Last updated
- 2021-11-16
- Certified
- 2021-11-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.