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General NPI Number Information
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NPI Number | 1437683679
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Entity Type | Organization
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Legal Business Name | LUTHERAN CHILD AND FAMILY SERVICE OF ILLINOIS
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Dates
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Enumeration Date | 04/14/2017
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Last Update Date | 11/11/2022
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Provider Practice Location Address
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Address Line | 2826 N. MONROE STREET
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City | DECATUR
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State | IL
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Zip | 62526
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Country | US
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Telephone | 217-428-8380
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Fax |
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Provider Business Mailing Address
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Address Line | ONE OAKBROOK TERRACE SUITE #501
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181
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Country | US
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Telephone | 708-771-7180
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Fax |
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Authorized Official
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Title or Position | SYSTEM SUPPORT ANALYST
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Name | JAMES ALLEN WEBSTER
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Credential |
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Telephone | 708-907-1583
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 12998-11
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License Number State | IL
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Taxonomy #7
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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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