Organization
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Active
Other names
Artesian CILA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY NOONAN (CHIEF FINANCIAL OFFICER)
(847) 635-4600
Entity
Organization
Contact information
Practice address
6255 N ARTESIAN AVE, CHICAGO, IL 60659-2828
(773) 274-9102
(773) 274-7502
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
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
926169
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
926169
DEPT OF HUMAN SERVICES
IL
Enumeration date
04/08/2008
Last updated
04/08/2008
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