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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