LUTHERAN SOCIAL SERVICES OF ILLINOIS NPI 1710599956

NPI Information

NPI: 1710599956
Provider Name: LUTHERAN SOCIAL SERVICES OF ILLINOIS
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
12940 WESTERN AVE STE 300
BLUE ISLAND, IL
ZIP 60406
Phone: (708) 489-2894
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LUTHERAN SOCIAL SERVICES OF ILLINOIS is a mental health (including community mental health center) clinic center in Blue Island, IL. LUTHERAN SOCIAL SERVICES OF ILLINOIS NPI is 1710599956. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12940 WESTERN AVE STE 300
BLUE ISLAND, IL
ZIP 60406-154
Phone: (708) 489-2894
Fax: (708) 489-5413

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 8/19/2020 and was last updated on 8/19/2020.

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	Primary
1	103TC0700X	Psychologist	Clinical	No
2	1041C0700X	Social Worker	Clinical	No
3	207Q00000X	Family Medicine		No
4	363L00000X	Nurse Practitioner		No
5	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	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: 11/14/2023

NPI Synchronization or Removal

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