LUTHERAN SOCIAL SERVICES OF ILLINOIS (NPI# 1710599956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710599956 |
| Entity Type | Organization |
| Organization Name | LUTHERAN SOCIAL SERVICES OF ILLINOIS |
| Practice Address |
12940 Western Ave Ste 300 Blue Island IL 60406-4154 |
| Mailing Address |
1001 E Touhy Ave Ste 50 Des Plaines IL 60018-5817 |
| Practice Telephone | 7084892894 |
| Practice Fax Number | 7084895413 |
| Mailing Telephone | 8476354600 |
| Mailing Fax Number | 8472973407 |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-19 |
| Authorized Official Name | MARK STUTRUD (PRESIDENT) |
| Authorized Official Telephone | 8476354600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| LSSI Blue Island | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881206035 | Lutheran Social Services of Illinois | Psychologist | 45 Industrial Dr, Vienna, IL 62995-1674 | 2020-08-19 |
| 1235741745 | Lutheran Social Services of Illinois | Psychologist | 102 E Deyoung St, Marion, IL 62959-2724 | 2020-08-18 |
| 1922634021 | Lutheran Social Services of Illinois | Clinic/Center | 400 N Cherry St, Morrison, IL 61270-2605 | 2020-03-20 |
| 1477904555 | Lutheran Social Services of Illinois | Counselor | 16248 S Parker Rd, Homer Glen, IL 60491-9081 | 2016-06-29 |
| 1760857213 | Lutheran Social Services of Illinois | Counselor | 6201 S Sangamon St, Ste 101, Chicago, IL 60621-2005 | 2015-12-09 |
| 1104200237 | Lutheran Social Services of Illinois | Clinic/Center | 85 Hankes Ave, Aurora, IL 60505-1774 | 2015-07-18 |
| 1194104661 | Lutheran Social Services of Illinois | Counselor | 402 Kishwaukee St, Ste 101, Rockford, IL 61104-2041 | 2015-05-29 |
| 1578942108 | Lutheran Social Services of Illinois | Counselor | 1798 Summit Ave, Ste 104, East Saint Louis, IL 62205-2800 | 2015-05-28 |
| 1356744056 | Lutheran Social Services of Illinois | In Home Supportive Care | 815 W 63rd St, 3rd Floor, Chicago, IL 60621-1917 | 2014-10-08 |
| 1013310705 | Lutheran Social Services of Illinois | In Home Supportive Care | 1111 S Alpine Rd, Suite 201, Rockford, IL 61108-3940 | 2014-10-08 |
| Street Address |
12940 WESTERN AVE STE 300 |
| City | BLUE ISLAND |
| State | IL |
| Zip Code | 60406-4154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780205708 | Cook County | Family Medicine | 12757 S. Western Ave, Blue Island, IL 60406 | 2020-04-30 |
| 1942842810 | Blue Island Smiles PC | Dentist | 12059 Western Avenue, Blue Island, IL 60406 | 2019-10-12 |
| 1609438738 | Maisha Safford | Developmental Therapist | 2262 W. 120th Place, Blue Island, IL 60406 | 2019-06-28 |
| 1891279709 | Renjith Thomas | Physical Therapy Assistant | Therapy Department, 1546 W Water Stret, Blue Island, IL 60406 | 2018-09-18 |
| 1982182994 | Lifehouse Health Group,llc | Clinic/Center | 14127 Levitt Ave, Dixmoor, IL 60406 | 2018-08-01 |
| 1063923159 | Sarah Lynn Presser | Speech-Language Pathologist | 2975 W Broadway, Blue Island, IL 60406 | 2017-10-17 |
| 1174070676 | Aunt Martha's Youth Service Center | Clinic/Center | 12139 S. Western Ave, Blue Island, IL 60406 | 2016-09-01 |
| 1427429141 | Pamela Kilcrease | Case Manager/Care Coordinator | 2247 119th Street, Apt 6, Blue Island, IL 60406 | 2015-10-08 |
| 1639587025 | D2 Dental At Oak Street, P.C. | Dentist | 3046 West 127th Street, Blue Island, IL 60406 | 2014-07-29 |
| 1700299658 | Daniel Ahrens | Optometrist | 13114 S Western Ave, Blue Island, IL 60406 | 2014-06-09 |
| Find all providers in zip 60406 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629283411 | Metropolitan Family Services | Clinic/Center | 13136 Western Ave, Blue Island, IL 60406-2423 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639990 | Mindy Forman, Psyd, LLC | Clinic/Center | 1020 Milwaukee Ave Ste 110, Deerfield, IL 60015-3555 | 2020-11-07 |
| 1346840295 | Stopka Professional Counseling LLC | Clinic/Center | 13125 Steeplechase Dr, New Lenox, IL 60451-1320 | 2020-10-29 |
| 1346848785 | Wellness Hearted Therapy LLC | Clinic/Center | 2675 S Cedar Glen Dr, Arlington Heights, IL 60005-5303 | 2020-10-16 |
| 1457959256 | Association for Individual Development | Clinic/Center | 708 N Bridge St, Yorkville, IL 60560-1105 | 2020-10-14 |
| 1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
| 1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
| 1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | BLUE ISLAND |
| Zip Code | 60406 |
Please comment or provide details below to improve the information on LUTHERAN SOCIAL SERVICES OF ILLINOIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.