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General NPI Number Information
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NPI Number | 1154890721
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Entity Type | Organization
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Legal Business Name | LUTHERAN SOCIAL SERVICES OF ILLINOIS
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 11/13/2018
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Provider Practice Location Address
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Address Line | 1550 S ALBANY AVE
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City | CHICAGO
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State | IL
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Zip | 60623-2212
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Country | US
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Telephone | 224-275-1978
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Fax | 847-297-3314
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Provider Business Mailing Address
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Address Line | 1001 E TOUHY AVE STE 170
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City | DES PLAINES
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State | IL
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Zip | 60018-5800
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Country | US
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Telephone | 847-390-4422
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Fax | 847-297-3314
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | GREERANN LOVETTE HAMBLET
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Credential |
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Telephone | 847-390-4422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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