LUTHERAN SOCIAL SERVICES OF ILLINOIS NPI 1063637684

NPI Information

LUTHERAN SOCIAL SERVICES OF ILLINOIS is a mental health (including community mental health center) clinic center in Chicago, IL. LUTHERAN SOCIAL SERVICES OF ILLINOIS NPI is 1063637684. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Portage Cragin Outpatient.

The provider's business location address is:

4840 W BYRON ST
CHICAGO, IL
ZIP 60641-712
Phone: (773) 282-7800
Fax: (773) 282-2163

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 4/17/2007 and was last updated on 12/31/2019.

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:

Other Identifiers

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.