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General NPI Number Information
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NPI Number | 1740652239
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Entity Type | Organization
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Legal Business Name | LEARN 9 CAMPUS IN WAUKEGAN
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Dates
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Enumeration Date | 10/23/2015
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Last Update Date | 10/23/2015
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Provider Practice Location Address
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Address Line | 540 S MCALISTER AVE
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City | WAUKEGAN
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State | IL
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Zip | 60085-6461
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Country | US
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Telephone | 312-343-2855
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Fax |
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Provider Business Mailing Address
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Address Line | 540 S MCALISTER AVE
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City | WAUKEGAN
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State | IL
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Zip | 60085-6461
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Country | US
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Telephone | 312-343-2855
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARGARET LONGO
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Credential |
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Telephone | 312-720-6696
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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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