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General NPI Number Information
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NPI Number | 1477904555
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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 | 06/29/2016
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 16248 S PARKER RD
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City | HOMER GLEN
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State | IL
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Zip | 60491-9081
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Country | US
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Telephone | 708-301-3885
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Fax | 708-301-1509
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Provider Business Mailing Address
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Address Line | 1001 E TOUHY AVE SUITE 170
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City | DES PLAINES
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State | IL
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Zip | 60018-5801
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Country | US
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Telephone | 847-635-4600
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Fax | 847-297-3407
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. GERALD NOONAN
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Credential |
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Telephone | 847-635-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | 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 | 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 #3
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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 #4
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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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 | 225100000X
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Taxonomy Name | Physical 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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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