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General NPI Number Information
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NPI Number | 1285496497
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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 | 01/24/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 612 WASHINGTON ST
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City | BEARDSTOWN
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State | IL
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Zip | 62618-1541
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Country | US
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Telephone | 217-323-5367
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Fax | 217-323-3791
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Provider Business Mailing Address
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Address Line | 1001 E TOUHY AVE STE 50
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City | DES PLAINES
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State | IL
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Zip | 60018-5817
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Country | US
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Telephone | 847-390-1422
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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 | MRS. GREERANN LOVETTE SIMS
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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