| Lutheran Social Services Of Illinois | |
|
4840 W Byron St Chicago IL 60641-2712 | |
| (773) 282-7800 | |
| (773) 282-2163 |
| Full Name | Lutheran Social Services Of Illinois |
|---|---|
| Speciality | Clinic/Center |
| Location | 4840 W Byron St, Chicago, Illinois |
| Authorized Official Name and Position | Mark Stutrud (PRESIDENT) |
| Authorized Official Contact | 8476354600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Social Services Of Illinois 1001 E Touhy Ave Ste 50 Des Plaines IL 60018-5817 Ph: (847) 635-4600 | Lutheran Social Services Of Illinois 4840 W Byron St Chicago IL 60641-2712 Ph: (773) 282-7800 |
| NPI Number | 1063637684 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 12/31/2019 |
| Certification Date | 12/31/2019 |
| Medicare PECOS PAC ID | 2163403551 |
|---|---|
| Medicare Enrollment ID | O20050322001114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063637684 | NPI | - | NPPES |
| 0001618748 | Other | IL | BLUE CROSS BLUE SHIELD |
| Provider Name | Terrill Applewhite |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205910114 PECOS PAC ID: 5496702193 Enrollment ID: I20050405000775 |
| Provider Name | Lisa E Siegel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104926906 PECOS PAC ID: 2466450762 Enrollment ID: I20061121000350 |
| Provider Name | Patricia R Pipp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679738348 PECOS PAC ID: 7517025604 Enrollment ID: I20081017000508 |
| Provider Name | Paula R Christiansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235334426 PECOS PAC ID: 0244399350 Enrollment ID: I20081104000696 |
| Provider Name | Colleen A Mikula |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518081686 PECOS PAC ID: 1456400761 Enrollment ID: I20090515000382 |
| Provider Name | Margaret Andrews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023150935 PECOS PAC ID: 0749469278 Enrollment ID: I20110128000886 |
| Provider Name | Deep Buch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518113786 PECOS PAC ID: 7012162951 Enrollment ID: I20130227000114 |
| Provider Name | Susan E Niezgoda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952491110 PECOS PAC ID: 9032197298 Enrollment ID: I20140416000917 |
| Provider Name | Marian R Glenn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265858013 PECOS PAC ID: 9830314715 Enrollment ID: I20140709001052 |
| Provider Name | Jaime Esquivel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285812925 PECOS PAC ID: 0840501631 Enrollment ID: I20150619001799 |
| Provider Name | Monica C Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952784605 PECOS PAC ID: 8426360264 Enrollment ID: I20150707002898 |
| Provider Name | Katie Dcruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124412168 PECOS PAC ID: 0941513642 Enrollment ID: I20150724010096 |
| Provider Name | Peter W Nichols |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013112143 PECOS PAC ID: 1759690811 Enrollment ID: I20151013000290 |
| Provider Name | Paul E Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073060620 PECOS PAC ID: 0547548554 Enrollment ID: I20161026001415 |
| Provider Name | Valerie Y Riley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134580335 PECOS PAC ID: 3476813791 Enrollment ID: I20180207000270 |
| Provider Name | Aloha P Leblanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437665411 PECOS PAC ID: 1456613504 Enrollment ID: I20180329001508 |
| Provider Name | Donna Catherine Czech |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396104501 PECOS PAC ID: 3971800566 Enrollment ID: I20180823002267 |
| Provider Name | Leroy M Lambey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548754039 PECOS PAC ID: 9830448885 Enrollment ID: I20180823002743 |
| Provider Name | Patricia Grayson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841768660 PECOS PAC ID: 9830434497 Enrollment ID: I20181231000732 |
| Provider Name | Taryrsha Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821552761 PECOS PAC ID: 7911246368 Enrollment ID: I20190228002263 |
| Provider Name | Samantha R Dotson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932758968 PECOS PAC ID: 9032449871 Enrollment ID: I20190923000308 |
| Provider Name | Laura M Haberer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689207508 PECOS PAC ID: 2668897497 Enrollment ID: I20200810003535 |
| Provider Name | Lauren R Feld |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336542109 PECOS PAC ID: 8527478478 Enrollment ID: I20201103002694 |
| Provider Name | Arshad R Papa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730685561 PECOS PAC ID: 5395154694 Enrollment ID: I20210517000714 |
| Provider Name | Kofi Ankomah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356925440 PECOS PAC ID: 7214335363 Enrollment ID: I20211005000466 |
| Provider Name | Stephanie M Villarreal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558077453 PECOS PAC ID: 7113392283 Enrollment ID: I20230404001563 |
| Provider Name | Cawonda Ranee Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417648148 PECOS PAC ID: 3274994512 Enrollment ID: I20230802001846 |
| Provider Name | Kelsey P. Tevik |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609641885 PECOS PAC ID: 4789022278 Enrollment ID: I20240403000951 |
| Provider Name | Aileen D Apuli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558978080 PECOS PAC ID: 9739625831 Enrollment ID: I20240725001202 |
| Provider Name | Kylie M. Van Koevering |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497495246 PECOS PAC ID: 3375077290 Enrollment ID: I20241114000428 |
| Provider Name | Maria A Tekampe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376386870 PECOS PAC ID: 9537695044 Enrollment ID: I20241206003397 |
| Provider Name | Marisella Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033920277 PECOS PAC ID: 5597295840 Enrollment ID: I20250217000418 |
| Provider Name | Courtney Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619301546 PECOS PAC ID: 5193243673 Enrollment ID: I20250519001328 |
| Provider Name | Lauren E Gaborek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306502729 PECOS PAC ID: 5991224065 Enrollment ID: I20250522000894 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
The Thresholds Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |