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NPI 1396883625

NPI 1396883625 : NORTHWESTERN SUBURBAN SPECIAL EDUCATION ORGANIZATION : MT PROSPECT, IL

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General NPI Number Information
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    NPI Number           |    1396883625
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    Entity Type          |    Organization 
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    Legal Business Name  |    NORTHWESTERN SUBURBAN SPECIAL EDUCATION ORGANIZATION 
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Dates
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    Enumeration Date     |    02/01/2007
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    799 W KENSINGTON RD 
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    City                 |    MT PROSPECT
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    State                |    IL
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    Zip                  |    60056-1111
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    Country              |    US
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    Telephone            |    847-463-8120
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    799 W KENSINGTON RD 
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    City                 |    MT PROSPECT
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    State                |    IL
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    Zip                  |    60056-1111
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    Country              |    US
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    Telephone            |    847-463-8120
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    Fax                  |    
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Authorized Official
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    Title or Position    |    TECHNOLOGY COORDINATOR FOR MANAGEM
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    Name                 |     ADAM  DENENBERG 
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    Credential           |    M.E.D
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    Telephone            |    847-463-8120
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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       |    
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    License Number State |    
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