Provider Demographics
NPI:1194947770
Name:DONGOLA SCH UNIT DIST 66
Entity type:Organization
Organization Name:DONGOLA SCH UNIT DIST 66
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:D
Authorized Official - Last Name:DILLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-827-3841
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:1000 HIGH STREET
Mailing Address - City:DONGOLA
Mailing Address - State:IL
Mailing Address - Zip Code:62926-0190
Mailing Address - Country:US
Mailing Address - Phone:618-827-3841
Mailing Address - Fax:618-827-4641
Practice Address - Street 1:1000 HIGH STREET
Practice Address - Street 2:
Practice Address - City:DONGOLA
Practice Address - State:IL
Practice Address - Zip Code:62926
Practice Address - Country:US
Practice Address - Phone:618-827-3841
Practice Address - Fax:618-827-4641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid