MEDICARE: ILLINI BLUFFS CU SCH DIST 327

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	:	1194927608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ILLINI BLUFFS CU SCH DIST 327

Provider Business Mailing Address
First Line	:	9611 S HANNA CITY-GLASFOR
Second Line	:
City	:	GLASFORD
State	:	IL
Zip	:	61533-9801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9611 S HANNA CITY-GLASFOR
Second Line	:
City	:	GLASFORD
State	:	IL
Zip	:	61533-9801
Country	:	US
Telephone Number	:	309-697-0880
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JANE WINTER CLARK
Credential	:
Telephone Number	:	309-697-0880

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	08/22/2020

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