NPIMap

Organization Active NPI

LDS Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Glen Ellyn, IL
National Provider Identifier
1346402302
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
1073685715 Issued in IL
Legal business name
LDS FAMILY SERVICES
Practice address
45 S Park Blvd
Suite 255
Glen Ellyn, IL 60137-6280
Phone
(630) 942-8803
NPI assigned
Jun 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
David S Wood, PHD
Title
Agency Director
Phone
(630) 942-8803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 1073685715 IL Primary

Addresses

Primary practice location

45 S Park Blvd
Suite 255
Glen Ellyn, IL 60137-6280

Mailing address

45 S Park Blvd
Suite 255
Glen Ellyn, IL 60137-6280
Phone (630) 942-8803

National Provider Directory

National Provider Directory
Tax ID family
Robert D Smith PHD46 organizations share this tax ID, including this one

Other organizations with this tax ID 45

Organizations that report the same tax identification number in the National Provider Directory.

View all 45

Locations

45 S Park Blvd
Ste 255
Glen Ellyn, IL 60137
Phone (630) 942-8803

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 10

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": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1346402302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 S PARK BLVD",
            "address_2": "SUITE 255",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376280",
            "telephone_number": "630-942-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 S PARK BLVD",
            "address_2": "SUITE 255",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376280",
            "telephone_number": "630-942-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDS FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "630-942-8803",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "1073685715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.