LUTHERAN SOCIAL SERVICES OF ILLINOIS (NPI# 1932318920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932318920 |
| Entity Type | Organization |
| Organization Name | LUTHERAN SOCIAL SERVICES OF ILLINOIS |
| Other Organization Name | BHS KENMORE FACILITY |
| Practice Address |
5517 N Kenmore Ave Chicago IL 60640-1515 |
| Mailing Address |
1001 E Touhy Ave Ste 50 Des Plaines IL 60018-5817 |
| Practice Telephone | 7732757962 |
| Practice Fax Number | 7732750728 |
| Mailing Telephone | 8476354600 |
| Mailing Fax Number | 8472973407 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | MARK STUTRUD (PRESIDENT) |
| Authorized Official Telephone | 8473904651 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 324500000X | Substance Abuse Rehabilitation Facility | A-0286-0011-A | IL | Residential Treatment Facilities |
| N | 324500000X | Substance Abuse Rehabilitation Facility | A-0286-0008-A | IL | Residential Treatment Facilities |
| N | 324500000X | Substance Abuse Rehabilitation Facility | A-0286-0012-A | IL | Residential Treatment Facilities |
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
A-0286-0009-A | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| BHS Kenmore Facility | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881206035 | Lutheran Social Services of Illinois | Psychologist | 45 Industrial Dr, Vienna, IL 62995-1674 | 2020-08-19 |
| 1710599956 | Lutheran Social Services of Illinois | Psychologist | 12940 Western Ave Ste 300, Blue Island, IL 60406-4154 | 2020-08-19 |
| 1235741745 | Lutheran Social Services of Illinois | Psychologist | 102 E Deyoung St, Marion, IL 62959-2724 | 2020-08-18 |
| 1922634021 | Lutheran Social Services of Illinois | Clinic/Center | 400 N Cherry St, Morrison, IL 61270-2605 | 2020-03-20 |
| 1477904555 | Lutheran Social Services of Illinois | Counselor | 16248 S Parker Rd, Homer Glen, IL 60491-9081 | 2016-06-29 |
| 1760857213 | Lutheran Social Services of Illinois | Counselor | 6201 S Sangamon St, Ste 101, Chicago, IL 60621-2005 | 2015-12-09 |
| 1104200237 | Lutheran Social Services of Illinois | Clinic/Center | 85 Hankes Ave, Aurora, IL 60505-1774 | 2015-07-18 |
| 1194104661 | Lutheran Social Services of Illinois | Counselor | 402 Kishwaukee St, Ste 101, Rockford, IL 61104-2041 | 2015-05-29 |
| 1578942108 | Lutheran Social Services of Illinois | Counselor | 1798 Summit Ave, Ste 104, East Saint Louis, IL 62205-2800 | 2015-05-28 |
| 1356744056 | Lutheran Social Services of Illinois | In Home Supportive Care | 815 W 63rd St, 3rd Floor, Chicago, IL 60621-1917 | 2014-10-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | LUTHERAN SOCIAL SERVICES OF ILLINOIS | 880 Lee St, Des Plaines, IL 60016 |
| Street Address |
5517 N KENMORE AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640-1515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861980435 | Stevnika Russell | Licensed Practical Nurse | 5517 N Kenmore Ave, Chicago, IL 60640-1515 | 2018-04-28 |
| 1194213009 | Kathy Sanders | Registered Nurse | 5517 N Kenmore Ave, Chicago, IL 60640-1515 | 2018-04-26 |
| 1770071797 | Erica Danielle Lindsey | Licensed Practical Nurse | 5517 N Kenmore Ave, Chicago, IL 60640-1515 | 2018-04-25 |
| 1124574652 | Melissa Gustafson | Social Worker | 5517 N Kenmore Ave, Chicago, IL 60640-1515 | 2016-08-25 |
| 1982065215 | Lenita Miller | Registered Nurse | 5517 N Kenmore Ave, Chicago, IL 60640-1515 | 2016-03-15 |
| 1215398680 | Deana Zamora | Licensed Practical Nurse | 5517 N Kenmore Ave, Chicago, IL 60640-1515 | 2016-03-14 |
| 1558721621 | Suzzette Brown | Registered Nurse | 5517 N Kenmore Ave, Chicago, IL 60640-1515 | 2016-03-02 |
| 1891155255 | Rigoberto Acosta | Licensed Practical Nurse | 5517 N Kenmore Ave, Chicago, IL 60640-1515 | 2016-02-28 |
| 1295195618 | Kristen Ward | Registered Nurse | 5517 N Kenmore Ave, Chicago, IL 60640-1515 | 2016-02-26 |
| 1841650454 | Jonathan Hilliard | Licensed Practical Nurse | 5517 N Kenmore Ave, Chicago, IL 60640-1515 | 2016-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
| Find all providers in zip 60640 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144852260 | Vincent Wallace | Clinic/Center | 226 W Ontario St, Chicago, IL 60654-3619 | 2020-02-06 |
| 1053957993 | Safer Foundation | Clinic/Center | 769 W Jackson, Unit G, Chicago, IL 60661 | 2019-11-26 |
| 1255977195 | Safer Foundation | Clinic/Center | 6352 W Grand Ave, Chicago, IL 60639-2650 | 2019-11-26 |
| 1063068492 | The Threshold | Clinic/Center | 3015 W Harrison St, Chicago, IL 60612 | 2019-08-12 |
| 1790338150 | Solleys House | Clinic/Center | 4163 S Archer Ave, Chicago, IL 60632-1870 | 2019-07-24 |
| 1366925489 | Lurie Children's Adolescent Substance Abuse and Prevention Progarm | Clinic/Center | 1440 N Dayton St, Chicago, IL 60642-2644 | 2018-09-13 |
| 1710482815 | Gateway Foundation, Inc. | Clinic/Center | 415 N Dearborn St Ste 510, Chicago, IL 60654-4626 | 2018-03-29 |
| 1366957292 | Maryville Academy | Clinic/Center | 1510 N Claremont Ave, Chicago, IL 60622-1710 | 2017-12-14 |
| 1053836395 | Aunt Martha's Health and Wellness, Inc. | Clinic/Center | 5001 S Michigan Ave Ste B, Chicago, IL 60615-2112 | 2017-08-08 |
| 1437679255 | Sixto Garcia | Clinic/Center | 1100 W. Cermak Rd, Chicago, IL 60608 | 2017-06-22 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.