Provider Demographics
NPI:1780449181
Name:LUTHERAN CHILD AND FAMILY SERVICES OF ILLINOIS
Entity type:Organization
Organization Name:LUTHERAN CHILD AND FAMILY SERVICES OF ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SYSTEM SUPPORT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-907-1583
Mailing Address - Street 1:1 OAKBROOK TER STE 501
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4479
Mailing Address - Country:US
Mailing Address - Phone:708-771-7180
Mailing Address - Fax:
Practice Address - Street 1:9730 S WESTERN AVE STE 418
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2777
Practice Address - Country:US
Practice Address - Phone:773-753-0600
Practice Address - Fax:773-753-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)