Lutheran Social Services of Illinois

NPI #1669645040 in Dixon, Illinois

Provider Information

NPI Number: 1669645040
Entity Type: Organization
Organization Name: Lutheran Social Services of Illinois
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 8, 2008
Last Updated: Apr 8, 2008

Practice Location

Address: 314 S OTTAWA AVE
City: Dixon
State: Illinois
ZIP Code: 61021-3150
Phone: (815) 288-4108

Authorized Official

Name: MR. JERRY NOONAN
Title: CHIEF FINANCIAL OFFICER
Phone: (847) 635-4600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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