NPIMap

Organization Active NPI

Lutheran Social Services of Illinois

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dixon, IL
National Provider Identifier
1992915698
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
A-0286-0010-A Issued in IL
Legal business name
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Practice address
1247 N. Galena Avenue
Dixon, IL 61021-1000
Phone
(815) 288-6655
Fax
(815) 288-2723
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Gerald Noonan
Title
Chief Financial Officer
Phone
(847) 635-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-0286-0010-A IL Primary

Addresses

Primary practice location

1247 N. Galena Avenue
Dixon, IL 61021-1000

Mailing address

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

Other names 1

  • BHS Dixon 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 12

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

Locations

1247 N Galena Ave
Dixon, IL 61021
Phone (815) 288-6655

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992915698",
    "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": "1247 N. GALENA AVENUE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610211000",
            "telephone_number": "815-288-6655",
            "fax_number": "815-288-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOONAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "847-635-4600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-0286-0010-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BHS Dixon Facility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.