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General NPI Number Information
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NPI Number | 1245715655
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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 | 10/02/2018
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 4840 W BYRON ST
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City | CHICAGO
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State | IL
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Zip | 60641-2712
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Country | US
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Telephone | 773-282-7800
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Fax | 773-282-2163
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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 | 847-297-3407
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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 | 847-390-1422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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