Organization
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Active
Organization
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Active
Other names
BHS Kenmore Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MARK STUTRUD (PRESIDENT)
(847) 390-4651
Entity
Organization
Contact information
Practice address
5517 N KENMORE AVE, CHICAGO, IL 60640-1515
(773) 275-7962
(773) 275-0728
Mailing address
1001 E TOUHY AVE STE 50, DES PLAINES, IL 60018-5817
(847) 635-4600
(847) 297-3407
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
A-0286-0009-A
IL
324500000X
Substance Abuse Rehabilitation Facility
A-0286-0008-A
IL
324500000X
Substance Abuse Rehabilitation Facility
A-0286-0011-A
IL
324500000X
Substance Abuse Rehabilitation Facility
A-0286-0012-A
IL
Other
Enumeration date
05/22/2007
Last updated
08/13/2020
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