MEDICARE: COMMUNITY CSD 59

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	:	1396876207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY CSD 59

Provider Business Mailing Address
First Line	:	2123 S ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-4105
Country	:	US
Telephone Number	:	847-593-4335
Fax Number	:	847-593-4352

Provider Business Practice Location Address
First Line	:	2123 S ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-4105
Country	:	US
Telephone Number	:	847-593-4335
Fax Number	:	847-593-4352

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JENNY PLACEK
Credential	:
Telephone Number	:	847-593-4335

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	05/15/2008

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