Provider Demographics
NPI:1194902429
Name:PLEASANTDALE SCHOOL DISTRICT 107
Entity type:Organization
Organization Name:PLEASANTDALE SCHOOL DISTRICT 107
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDISDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-784-8013
Mailing Address - Street 1:7450 WOLF RD
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7714
Mailing Address - Country:US
Mailing Address - Phone:708-784-2013
Mailing Address - Fax:708-246-0161
Practice Address - Street 1:7450 WOLF RD
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-7714
Practice Address - Country:US
Practice Address - Phone:708-784-2013
Practice Address - Fax:708-246-0161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)