Organization
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Active
Other names
LSSI MADO Healthcare Douglas Park
Organization subpart
No
Provider details
NPI number
Authorized official
GREERANN LOVETTE HAMBLET (BUSINESS MANAGER)
(847) 390-4422
Entity
Organization
Contact information
Practice address
1550 S ALBANY AVE, CHICAGO, IL 60623-2212
(224) 275-1978
(847) 297-3314
Mailing address
1001 E TOUHY AVE STE 170, DES PLAINES, IL 60018-5800
(847) 390-4422
(847) 297-3314
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A-02860029-A
—
IL
Enumeration date
11/13/2018
Last updated
11/13/2018
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