MEDICARE: MILFORD AREA PUBLIC SCHOOLS DISTRICT 124

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1164822755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILFORD AREA PUBLIC SCHOOLS DISTRICT 124

Provider Business Mailing Address
First Line	:	208 S CHICAGO ST
Second Line	:	PO BOX 304
City	:	MILFORD
State	:	IL
Zip	:	60953-1234
Country	:	US
Telephone Number	:	815-889-5176
Fax Number	:	815-889-5221

Provider Business Practice Location Address
First Line	:	208 S CHICAGO ST
Second Line	:
City	:	MILFORD
State	:	IL
Zip	:	60953-1234
Country	:	US
Telephone Number	:	815-889-5176
Fax Number	:	815-889-5221

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	DR. DALE KENT HASTINGS
Credential	:	ED.D.
Telephone Number	:	815-889-5176

Provider Enumeration Date	:	09/02/2014
Last Update Date	:	09/02/2014

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