MEDICARE: NEWARK GRADE SCHOOL #66

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	:	1801949060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEWARK GRADE SCHOOL #66

Provider Business Mailing Address
First Line	:	503 CHICAGO RD
Second Line	:
City	:	NEWARK
State	:	IL
Zip	:	60541-9501
Country	:	US
Telephone Number	:	815-695-5143
Fax Number	:	815-695-5776

Provider Business Practice Location Address
First Line	:	503 CHICAGO RD
Second Line	:
City	:	NEWARK
State	:	IL
Zip	:	60541-9501
Country	:	US
Telephone Number	:	815-695-5143
Fax Number	:	815-695-5776

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. JOHN DEMAY
Credential	:
Telephone Number	:	815-695-5143

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	08/22/2020

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Directions to “NEWARK GRADE SCHOOL #66 ” Practice Location

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