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NPI Code Detail

MEDICARE: BLOOM TOWNSHIP SCHOOL DISTRICT 206

MEDICARE: BLOOM TOWNSHIP SCHOOL DISTRICT 206
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)IL

General Provider Information

NPI Number : 1518002740
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLOOM TOWNSHIP SCHOOL DISTRICT 206
Provider Business Mailing Address
First Line : 100 W 10TH ST
Second Line :
City : CHICAGO HEIGHTS
State : IL
Zip : 60411-2002
Country : US
Telephone Number : 708-755-7010
Fax Number :
Provider Business Practice Location Address
First Line : 100 W 10TH ST
Second Line :
City : CHICAGO HEIGHTS
State : IL
Zip : 60411-2002
Country : US
Telephone Number : 708-755-7010
Fax Number :
Authorized Official
Title or Position : ASSISTANT SUPERINTENDENT-BUSINESS
Name : MARK SHEAHAN
Credential : MBA
Telephone Number : 708-755-7010
Provider Enumeration Date : 02/21/2007
Last Update Date : 08/22/2020

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Directions to “BLOOM TOWNSHIP SCHOOL DISTRICT 206 ” Practice Location

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