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General NPI Number Information
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NPI Number | 1326217035
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Entity Type | Organization
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Legal Business Name | COUNTY OF WILL, SD #88
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 400 ELSIE AVE
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City | CREST HILL
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State | IL
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Zip | 60403-2573
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Country | US
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Telephone | 815-722-6673
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Fax | 815-722-7814
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Provider Business Mailing Address
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Address Line | 400 ELSIE AVE
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City | CREST HILL
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State | IL
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Zip | 60403-2573
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Country | US
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Telephone | 815-722-6673
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Fax | 815-722-7814
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | MR. ANDY SIEGFRIED
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Credential |
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Telephone | 815-722-6673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 56099088002
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License Number State | IL
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