Organization
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Active
Other names
Behavioral Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD NOONAN (CHIEF FINANCIAL OFFICER)
(847) 635-4600
Entity
Organization
Contact information
Practice address
4840 W BYRON ST, CHICAGO, IL 60641-2712
(773) 282-7800
(773) 282-2163
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
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091774
—
IL
05
—
036092099
—
IL
05
—
036094832
—
IL
05
—
036095776
—
IL
05
—
036105330
—
IL
05
—
036111400
—
IL
05
—
036113899
—
IL
Enumeration date
04/30/2009
Last updated
04/30/2009
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