| Lutheran Social Services Of Il | |
|
3000 W Rohmann Ave West Peoria IL 61604-4842 | |
| (309) 671-0300 | |
| (309) 671-0503 |
| Full Name | Lutheran Social Services Of Il |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3000 W Rohmann Ave, West Peoria, Illinois |
| Authorized Official Name and Position | Gerald Edmund Noonan (V.P. FINANCE/CFO) |
| Authorized Official Contact | 8476354600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Social Services Of Il 1001 E Touhy Ave Suite 50 Des Plaines IL 60018-5801 Ph: (847) 635-4600 | Lutheran Social Services Of Il 3000 W Rohmann Ave West Peoria IL 61604-4842 Ph: (309) 671-0300 |
| NPI Number | 1174576862 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 05/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174576862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 04092 (Illinois) | Primary |
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