Provider Demographics
NPI:1760435176
Name:LUTHERAN SOCIAL SERVICES OF ILLINOIS
Entity Type:Organization
Organization Name:LUTHERAN SOCIAL SERVICES OF ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:STUTRUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-390-1461
Mailing Address - Street 1:1001 E. TOUHY AVENUE
Mailing Address - Street 2:SUITE# 50
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-5801
Mailing Address - Country:US
Mailing Address - Phone:847-635-4600
Mailing Address - Fax:847-635-6764
Practice Address - Street 1:1001 E TOUHY AVENUE
Practice Address - Street 2:SUITE 50
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018
Practice Address - Country:US
Practice Address - Phone:847-390-1465
Practice Address - Fax:847-297-3407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL013005251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable