Organization
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Active
Organization
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Active
Other names
LSSI MADO Healthcare Buena Park
Organization subpart
No
Provider details
NPI number
Authorized official
GREERANN LOVETTE HAMBLET (BUSINESS MANAGER)
(847) 390-1422
Entity
Organization
Contact information
Practice address
940 W CULLOM AVE, CHICAGO, IL 60613-1619
(224) 275-1978
(847) 297-3314
Mailing address
1001 E TOUHY AVE STE 170, DES PLAINES, IL 60018-5800
(847) 390-1422
(847) 297-3407
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-0286-0031-A
—
IL
Enumeration date
04/12/2019
Last updated
04/12/2019
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