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NPI Code Detail

MEDICARE: CICERO DISTRICT 99

MEDICARE: CICERO DISTRICT 99
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
1251300000XLocal Education Agency (LEA)

General Provider Information

NPI Number : 1225206352
Entity Type Code : Organization
Provider Name (Legal Business Name) : CICERO DISTRICT 99
Provider Business Mailing Address
First Line : 5110 W 24TH ST
Second Line :
City : CICERO
State : IL
Zip : 60804-2948
Country : US
Telephone Number : 708-863-4856
Fax Number :
Provider Business Practice Location Address
First Line : 5110 W 24TH ST
Second Line :
City : CICERO
State : IL
Zip : 60804-2948
Country : US
Telephone Number : 708-863-4856
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MARGE CIESLWIWICCZ
Credential :
Telephone Number : 708-863-4856
Provider Enumeration Date : 02/12/2008
Last Update Date : 04/20/2008

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Directions to “CICERO DISTRICT 99 ” Practice Location

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