LUTHERAN SOCIAL SERVICES OF ILLINOIS NPI 1104200237

NPI Information

NPI: 1104200237
Provider Name: LUTHERAN SOCIAL SERVICES OF ILLINOIS
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
85 HANKES AVE
AURORA, IL
ZIP 60505
Phone: (630) 896-2714
Get Directions

LUTHERAN SOCIAL SERVICES OF ILLINOIS is a mental health (including community mental health center) clinic center in Aurora, IL. LUTHERAN SOCIAL SERVICES OF ILLINOIS NPI is 1104200237. The provider is registered as an organization entity type.

The provider's business location address is:

85 HANKES AVE
AURORA, IL
ZIP 60505-774
Phone: (630) 896-2714
Fax: (630) 896-5613

The provider's authorized official is Mark Stutrud .
The authorized official title is President and has the following contact phone number (847) 635-4600.

The enumeration date for this NPI number is 7/18/2015 and was last updated on 1/3/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	04092	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	04092	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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