MEDICARE: PROSPECT HEIGHTS SCHOOL DISTRICT 23

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	:	1518005842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROSPECT HEIGHTS SCHOOL DISTRICT 23

Provider Business Mailing Address
First Line	:	700 N SCHOENBECK RD
Second Line	:
City	:	PROSPECT HEIGHTS
State	:	IL
Zip	:	60070-1231
Country	:	US
Telephone Number	:	847-870-3850
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 N SCHOENBECK RD
Second Line	:
City	:	PROSPECT HEIGHTS
State	:	IL
Zip	:	60070-1231
Country	:	US
Telephone Number	:	847-870-3850
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT SUPERINTENDENT
Name	:	JAN EWING
Credential	:
Telephone Number	:	847-870-3850

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	08/22/2020

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