LUTHERAN SOCIAL SERVICES OF IL NPI 1366762064

NPI Information

NPI: 1366762064
Provider Name: LUTHERAN SOCIAL SERVICES OF IL
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
308 W STATE ST STE 205
ROCKFORD, IL
ZIP 61101
Phone: (815) 969-8836
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LUTHERAN SOCIAL SERVICES OF IL is a mental health (including community mental health center) clinic center in Rockford, IL. LUTHERAN SOCIAL SERVICES OF IL NPI is 1366762064. The provider is registered as an organization entity type.

The provider's business location address is:

308 W STATE ST STE 205
ROCKFORD, IL
ZIP 61101-117
Phone: (815) 969-8836
Fax: (815) 969-8871

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 6/3/2010 and was last updated on 1/8/2020.

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

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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