OrganizationActive
Lutheran Social Services of Illinois
NPI 1164633657 · Intellectual Disabilities Intermediate Care Facility · Lockport, IL
Provider details
- NPI number
- 1164633657
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Gerald Noonan, Chief Financial Officer(847) 635-4600
- License
- 0040527 (IL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
16220 S Parker Rd
Lockport, IL 60491-9081
Phone: (708) 301-0571
Fax: (708) 301-0573
Street-level locationGet directions
Mailing address
1001 E Touhy Ave
Des Plaines, IL 60018-5801
Other names (DBA / former)
- Other name
- Shady Oaks West
Registry dates
- Enumerated
- 2007-05-25
- Last updated
- 2016-07-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.