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General NPI Number Information
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NPI Number | 1831544378
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Entity Type | Organization
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Legal Business Name | LUTHERAN SOCIAL SERVICES OF IL
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Dates
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Enumeration Date | 05/03/2016
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 2740 W FOSTER AVE STE 103
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City | CHICAGO
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State | IL
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Zip | 60625-3500
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Country | US
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Telephone | 773-561-5809
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Fax |
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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 | 60018-5801
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Country | US
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Telephone | 847-635-4600
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Fax |
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Authorized Official
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Title or Position | VP OF HOME & COMMUNITY BASED SERVIC
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Name | TIM SHEEHAN
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Credential |
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Telephone | 773-443-3562
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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 | 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 #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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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 | 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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