MEDICARE: CRESCENT IROQUOIS CUSD 249

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	:	1770751067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCENT IROQUOIS CUSD 249

Provider Business Mailing Address
First Line	:	600 SOUTH STREET
Second Line	:
City	:	CRESCENT CITY
State	:	IL
Zip	:	60928
Country	:	US
Telephone Number	:	815-683-2141
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 SOUTH STREET
Second Line	:
City	:	CRESCENT CITY
State	:	IL
Zip	:	60928
Country	:	US
Telephone Number	:	815-683-2141
Fax Number	:

Authorized Official
Title or Position	:	BUSINSS MANAGER
Name	:	CARLOYN RAPP
Credential	:
Telephone Number	:	815-683-2141

Provider Enumeration Date	:	02/20/2008
Last Update Date	:	02/20/2008

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