=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114042884
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCHAUMBURG CCSD 54
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2007
-----------------------------------------------------
Last Update Date | 03/15/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 524 E SCHAUMBURG RD
-----------------------------------------------------
City | SCHAUMBURG
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60194-3510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-357-5052
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 524 E SCHAUMBURG RD
-----------------------------------------------------
City | SCHAUMBURG
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60194-3510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-357-5052
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COORDINATOR
-----------------------------------------------------
Name | SHEILA MCGREEVY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 847-357-5052
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------