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Contact Information

LUTHERAN SOCIAL SERVICES OF ILLINOIS
4840 W BYRON ST
CHICAGO, IL60641-2712
 Phone: 773-282-7800
 Fax: 773-282-2163
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for LUTHERAN SOCIAL SERVICES OF ILLINOIS

NPI Number 1265676597
LBN Legal business name LUTHERAN SOCIAL SERVICES OF ILLINOIS
Authorized official GERALD NOONAN - (CHIEF FINANCIAL OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/30/2009
Last updated 04/30/2009 - About 17 years ago
Identifiers
IL Medicaid 036091774
IL Medicaid 036092099
IL Medicaid 036094832
IL Medicaid 036095776
IL Medicaid 036105330
IL Medicaid 036111400
IL Medicaid 036113899
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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