LUTHERAN SOCIAL SERVICES OF IL NPI 1174576862

NPI Information

NPI: 1174576862
Provider Name: LUTHERAN SOCIAL SERVICES OF IL
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
3000 W ROHMANN AVE
WEST PEORIA, IL
ZIP 61604
Phone: (309) 671-0300
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LUTHERAN SOCIAL SERVICES OF IL is a mental health (including community mental health center) clinic center in West Peoria, IL. LUTHERAN SOCIAL SERVICES OF IL NPI is 1174576862. The provider is registered as an organization entity type.

The provider's business location address is:

3000 W ROHMANN AVE
WEST PEORIA, IL
ZIP 61604-842
Phone: (309) 671-0300
Fax: (309) 671-0503

The provider's authorized official is Gerald Edmund Noonan .
The authorized official title is V.p. Finance/cfo and has the following contact phone number (847) 635-4600.

The enumeration date for this NPI number is 5/17/2006 and was last updated on 5/24/2010.

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	=========051	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: 11/14/2023

NPI Synchronization or Removal

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