Organization
LUTHERAN SOCIAL SERVICES OF IL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD EDMUND NOONAN (V.P. FINANCE / CFO)
(847) 635-4600
Entity
Organization
Contact information
Practice address
1616 W MAIN ST, MARION, IL 62959-1146
(618) 997-9196
(618) 997-6843
Mailing address
1001 E TOUHY AVE, SUITE 50, DES PLAINES, IL 60018-5801
(847) 635-4600
(847) 635-6764
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
027
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04092
—
IL
Enumeration date
05/17/2006
Last updated
07/21/2022
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