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Organization

LUTHERAN SOCIAL SERVICES OF ILLINOIS

Active
Other names
Far Northwest 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
6321 N AVONDALE AVE, SUITE A 101, CHICAGO, IL 60631-1900
(773) 774-7555
(773) 774-8910
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
04/17/2007
Last updated
06/19/2008
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