Healthcare Provider Details

I. General information

NPI: 1942357918
Provider Name (Legal Business Name): BROWNSTOWN CUSD 201
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 S COLLEGE AVE
BROWNSTOWN IL
62418-1129
US

IV. Provider business mailing address

421 S COLLEGE AVE
BROWNSTOWN IL
62418-1129
US

V. Phone/Fax

Practice location:
  • Phone: 618-427-3355
  • Fax: 618-427-3704
Mailing address:
  • Phone: 618-427-3355
  • Fax: 618-427-3704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MR. DOUG SLOVER
Title or Position: SUPERINTENDENT
Credential: M.A.
Phone: 618-427-3355