MEDICARE: LUTHERAN CHILD AND FAMILY SERVICE OF ILLINOIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	104100000X	Social Worker
5	1041C0700X	Clinical Social Worker
6	106H00000X	Marriage & Family Therapist
7	253J00000X	Foster Care Agency	012998-11	IL
8	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164820460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUTHERAN CHILD AND FAMILY SERVICE OF ILLINOIS

Provider Business Mailing Address
First Line	:	1 OAKBROOK TER STE 501
Second Line	:
City	:	OAKBROOK TERRACE
State	:	IL
Zip	:	60181-4479
Country	:	US
Telephone Number	:	708-771-7180
Fax Number	:	708-221-6005

Provider Business Practice Location Address
First Line	:	51 W JACKSON ST
Second Line	:
City	:	JOLIET
State	:	IL
Zip	:	60432-1729
Country	:	US
Telephone Number	:	815-409-4440
Fax Number	:

Authorized Official
Title or Position	:	SYSTEM SUPPORT ANALYST
Name	:	JAMES ALLEN WEBSTER
Credential	:
Telephone Number	:	708-907-1583

Provider Enumeration Date	:	12/18/2014
Last Update Date	:	06/14/2024

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Directions to “LUTHERAN CHILD AND FAMILY SERVICE OF ILLINOIS ” Practice Location

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