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NPI Code Detail

MEDICARE: EASTERN ILLINOIS AREA OF SPECIAL EDUCATION

MEDICARE: EASTERN ILLINOIS AREA OF SPECIAL EDUCATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251300000XLocal Education Agency (LEA)

General Provider Information

NPI Number : 1699874719
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTERN ILLINOIS AREA OF SPECIAL EDUCATION
Provider Business Mailing Address
First Line : 5837 PARK DR
Second Line : SUITE 1
City : CHARLESTON
State : IL
Zip : 61920-9460
Country : US
Telephone Number : 217-348-7700
Fax Number : 217-348-7704
Provider Business Practice Location Address
First Line : 5837 PARK DR
Second Line : SUITE 1
City : CHARLESTON
State : IL
Zip : 61920-9460
Country : US
Telephone Number : 217-348-7700
Fax Number : 217-348-7704
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MICHAEL ALT
Credential :
Telephone Number : 217-348-7700
Provider Enumeration Date : 09/22/2006
Last Update Date : 08/22/2020

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Directions to “EASTERN ILLINOIS AREA OF SPECIAL EDUCATION ” Practice Location

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