NPIMap

Organization Active NPI

Lutheran Social Services of Illinois

  • Clinical Social Worker
  • Sterling, IL
National Provider Identifier
1104235415
Registry record updated Aug 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015740 Issued in IL
Legal business name
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Practice address
1901 1St Ave
Sterling, IL 61081-1203
Phone
(815) 626-7333
Fax
(815) 626-8752
NPI assigned
Aug 12, 2014
Last updated
Aug 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2014

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

Authorized official

Name
Mr. David Jensen
Title
Coo/President
Phone
(847) 635-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149015740 IL Primary

Addresses

Primary practice location

1901 1St Ave
Sterling, IL 61081-1203

Mailing address

1001 E Touhy Ave
Suite# 170
Des Plaines, IL 60018-5801
Phone (847) 390-1422

Other identifiers 1

IdentifierTypeStateIssuer
149015740OtherILSTATE LICENSE

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1407801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407801600000",
    "number": "1104235415",
    "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": "847-390-1422",
            "fax_number": "847-297-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811203",
            "telephone_number": "815-626-7333",
            "fax_number": "815-626-8752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-12",
        "last_updated": "2014-08-12",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO/PRESIDENT",
        "authorized_official_telephone_number": "847-635-4600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "149015740",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.