Provider Demographics
NPI:1215073549
Name:NORTH WAYNE C.U. SCHOOL DIST. #200
Entity type:Organization
Organization Name:NORTH WAYNE C.U. SCHOOL DIST. #200
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-673-2151
Mailing Address - Street 1:206 MULBERRY ST.
Mailing Address - Street 2:P.O. BOX 235
Mailing Address - City:CISNE
Mailing Address - State:IL
Mailing Address - Zip Code:62823
Mailing Address - Country:US
Mailing Address - Phone:618-673-2151
Mailing Address - Fax:618-673-2152
Practice Address - Street 1:206 MULBERRY ST.
Practice Address - Street 2:
Practice Address - City:CISNE
Practice Address - State:IL
Practice Address - Zip Code:62823
Practice Address - Country:US
Practice Address - Phone:618-673-2151
Practice Address - Fax:618-673-2152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========002Medicaid