NPIMap

Organization Active NPI

Lutheran Social Services of Illinois

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chicago, IL
National Provider Identifier
1932318920
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
A-0286-0009-A Issued in IL
Legal business name
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Practice address
5517 N Kenmore Ave
Chicago, IL 60640-1515
Phone
(773) 275-7962
Fax
(773) 275-0728
NPI assigned
May 22, 2007
Last updated
Aug 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Authorized official

Name
Mark Stutrud
Title
President
Phone
(847) 390-4651

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-0286-0009-A IL Primary
Substance Abuse Rehabilitation Facility 324500000X A-0286-0011-A IL
Substance Abuse Rehabilitation Facility 324500000X A-0286-0008-A IL
Substance Abuse Rehabilitation Facility 324500000X A-0286-0012-A IL

Addresses

Primary practice location

5517 N Kenmore Ave
Chicago, IL 60640-1515

Mailing address

1001 E Touhy Ave Ste 50
Des Plaines, IL 60018-5817
Phone (847) 635-4600

Other names 1

  • BHS Kenmore Facility 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 16

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

View all 16

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1932318920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E TOUHY AVE STE 50",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600185817",
            "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": "5517 N KENMORE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401515",
            "telephone_number": "773-275-7962",
            "fax_number": "773-275-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "STUTRUD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-390-4651"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-0286-0009-A",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "A-0286-0011-A",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "A-0286-0008-A",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "A-0286-0012-A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BHS Kenmore Facility",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "BHS Kenmore Facility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 13, 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.