Organization
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Active
Other names
Portage Cragin Psychiatric
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
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
04/18/2007
Last updated
06/19/2008
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