NPIMap

Organization Active NPI

Lutheran Social Service of Il

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1104146802
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
04092 Issued in IL
Legal business name
LUTHERAN SOCIAL SERVICE OF IL
Practice address
1340 S Damen Ave Ste 205
Chicago, IL 60608-1170
Phone
(312) 949-4340
Fax
(312) 243-1866
NPI assigned
Jun 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Authorized official

Name
Mr. Mark Stutrud
Title
President
Phone
(847) 635-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 04092 IL Primary

Addresses

Primary practice location

1340 S Damen Ave Ste 205
Chicago, IL 60608-1170

Mailing address

1001 E Touhy Ave
Suite 50
Des Plaines, IL 60018-5801
Phone (847) 635-4600

Other practice location 1

1340 S Damen Ave
Suite 205
Chicago, IL 60608-1169
Phone (312) 949-4340

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 17

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

View all 17

Locations

1340 S Damen Ave
Ste 205
Chicago, IL 60608
Phone (312) 949-4340

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1104146802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E TOUHY AVE",
            "address_2": "SUITE 50",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600185801",
            "telephone_number": "847-635-4600",
            "fax_number": "847-635-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 S DAMEN AVE STE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081170",
            "telephone_number": "312-949-4340",
            "fax_number": "312-243-1866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 S Damen Ave",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606081169",
            "country_code": "US",
            "telephone_number": "312-949-4340",
            "fax_number": "312-243-1866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICE OF IL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "STUTRUD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-635-4600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "04092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 8, 2020; 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.