Healthcare Provider Details

I. General information

NPI: 1669738563
Provider Name (Legal Business Name): CHRISTIAN SOCIAL SERVICES OF ILLINOIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 ROYAL HEIGHTS RD SUITE 1150
BELLEVILLE IL
62226-5457
US

IV. Provider business mailing address

8601 W MAIN ST STE. 201
BELLEVILLE IL
62223-1719
US

V. Phone/Fax

Practice location:
  • Phone: 618-688-1150
  • Fax: 618-277-7084
Mailing address:
  • Phone: 618-394-5900
  • Fax: 618-394-5909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number StateIL

VIII. Authorized Official

Name: MR. GARY HUELSMANN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 618-213-8705