1326216151 NPI number — LUTHERAN SOCIAL SERVICES OF ILLINOIS

Table of content: (NPI 1326216151)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326216151 NPI number — LUTHERAN SOCIAL SERVICES OF ILLINOIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUTHERAN SOCIAL SERVICES OF ILLINOIS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LSSI NACHUSA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326216151
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NACHUSA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
61057-0100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
815-284-7796
Provider Business Mailing Address Fax Number:
815-284-6162

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1261 IL RTE 38
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NACHUSA
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-284-7796
Provider Business Practice Location Address Fax Number:
815-284-6162
Provider Enumeration Date:
02/14/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STUTRUD
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
847-635-4600

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)