| Lutheran Social Services Of Illinois | |
|
85 Hankes Ave Aurora IL 60505-1774 | |
| (630) 896-2714 | |
| (630) 896-5613 |
| Full Name | Lutheran Social Services Of Illinois |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 85 Hankes Ave, Aurora, Illinois |
| Authorized Official Name and Position | Mark Stutrud (PRESIDENT) |
| Authorized Official Contact | 8476354600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Social Services Of Illinois 1001 E Touhy Ave Suite 50 Des Plaines IL 60018-5801 Ph: (847) 635-4600 | Lutheran Social Services Of Illinois 85 Hankes Ave Aurora IL 60505-1774 Ph: (630) 896-2714 |
| NPI Number | 1104200237 |
|---|---|
| Provider Enumeration Date | 07/18/2015 |
| Last Update Date | 01/03/2020 |
| Certification Date | 01/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104200237 | NPI | - | NPPES |
| 04092 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 04092 (Illinois) | Primary |
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