NPIMap

Organization Active NPI

Lutheran Social Services of Illinois

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Beardstown, IL
National Provider Identifier
1740453125
Registry record updated Apr 8, 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
612 Washington St
Beardstown, IL 62618-1541
Phone
(217) 323-5367
Fax
(217) 323-4559
NPI assigned
Apr 8, 2008
Last updated
Apr 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Mr. Jerry 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

612 Washington St
Beardstown, IL 62618-1541

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
926129OtherILDEPT OF HUMAN SERVICES

Other names 1

  • Washington Prader Willi Group Home 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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1740453125",
    "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": "612 WASHINGTON ST",
            "city": "BEARDSTOWN",
            "state": "IL",
            "postal_code": "626181541",
            "telephone_number": "217-323-5367",
            "fax_number": "217-323-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "NOONAN",
        "authorized_official_first_name": "JERRY",
        "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": "926129",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Prader Willi Group Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Beardstown, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.