NPIMap

Organization Active NPI

Lutheran Social Services of Illinois

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Chicago, IL
National Provider Identifier
1063683449
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
926169 Issued in IL
Legal business name
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Practice address
3120 W Palmer Square
Chicago, IL 60647
Phone
(773) 342-2055
Fax
(773) 342-2512
NPI assigned
Mar 13, 2008
Last updated
Mar 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Gerald Noonan
Title
Chief Financial Officer
Phone
(847) 635-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 926169 IL Primary

Addresses

Primary practice location

3120 W Palmer Square
Chicago, IL 60647

Mailing address

1001 E Touhy Ave
Suite 170
Des Plaines, IL 60018-5801
Phone (847) 635-4600

Other identifiers 1

IdentifierTypeStateIssuer
926169OtherILDEPT OF HUMAN SERVICES

Other names 1

  • Palmer Square Adult CILA Other name

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Social Services of Illinois65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

3120 W Palmer Blvd
Chicago, IL 60647
Phone (773) 342-2054

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1063683449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E TOUHY AVE",
            "address_2": "SUITE 170",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600185801",
            "telephone_number": "847-635-4600",
            "fax_number": "847-297-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 W PALMER SQUARE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60647",
            "telephone_number": "773-342-2055",
            "fax_number": "773-342-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "NOONAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "847-635-4600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "926169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF HUMAN SERVICES",
            "identifier": "926169",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmer Square Adult CILA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.