Organization
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Active
Other names
PA Peterson Center for Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD EDMUND NOONDUV (VP FINANCE CFO)
(847) 635-4600
Entity
Organization
Contact information
Practice address
1311 PARKVIEW AVE, ROCKFORD, IL 61107-1899
(815) 399-8832
(815) 399-8342
Mailing address
1001 E TOUHY AVE, DES PLAINES, IL 60018-5817
(847) 635-4600
(847) 390-1426
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0021238
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0021238
—
IL
Enumeration date
10/26/2005
Last updated
08/22/2020
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