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Organization
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Active
Organization
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Active
Other names
Far Northwest Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD NOONAN (CHIEF FINANCIAL OFFICER)
(847) 635-4600
Entity
Organization
Contact information
Practice address
6321 N AVONDALE AVE, SUITE A 101, CHICAGO, IL 60631-1900
(773) 774-7555
(773) 774-8910
Mailing address
1001 E TOUHY AVE, SUITE 170, DES PLAINES, IL 60018-5801
(847) 635-4600
(847) 297-3407
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001617952
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/12/2007
Last updated
09/11/2025
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