NPIMap

Organization Active NPI

Lutheran Social Services of Il

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Marion, IL
National Provider Identifier
1750334447
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
027 Issued in IL
Legal business name
LUTHERAN SOCIAL SERVICES OF IL
Practice address
1616 W Main St
Marion, IL 62959-1146
Phone
(618) 997-9196
Fax
(618) 997-6843
NPI assigned
May 17, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Gerald Edmund Noonan
Title
V.P. Finance / Cfo
Phone
(847) 635-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 027 IL Primary

Addresses

Primary practice location

1616 W Main St
Marion, IL 62959-1146

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
04092MedicaidIL

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

Locations

1616 W Main St
Marion, IL 62959
Phone (618) 288-8085

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1750334447",
    "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": "1616 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591146",
            "telephone_number": "618-997-9196",
            "fax_number": "618-997-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF IL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NOONAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "EDMUND",
        "authorized_official_title_or_position": "V.P. FINANCE / CFO",
        "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": "027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04092",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.