Provider Demographics
NPI:1194053579
Name:NEW LENOX SCHOOL DISTRICT 122
Entity type:Organization
Organization Name:NEW LENOX SCHOOL DISTRICT 122
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PPS
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMI
Authorized Official - Middle Name:L
Authorized Official - Last Name:PORTE-LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-462-2890
Mailing Address - Street 1:102 S CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-1702
Mailing Address - Country:US
Mailing Address - Phone:815-462-2890
Mailing Address - Fax:815-462-2894
Practice Address - Street 1:102 S CEDAR RD
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1702
Practice Address - Country:US
Practice Address - Phone:815-462-2890
Practice Address - Fax:815-462-2894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)