NPIMap

Organization Active NPI

Shawnee Cusd 84

  • Student Health Clinic/Center
  • Wolf Lake, IL
National Provider Identifier
1295906030
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
SHAWNEE CUSD 84
Practice address
3365 State Hwy 3 N
3364 State Hwy 3 N
Wolf Lake, IL 62998-0128
Phone
(618) 833-5709
Fax
(618) 833-4171
NPI assigned
Mar 20, 2008
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Debra L Seals
Title
Unit Secretary
Phone
(618) 833-5709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X IL Primary

Addresses

Primary practice location

3365 State Hwy 3 N
3364 State Hwy 3 N
Wolf Lake, IL 62998-0128

Mailing address

PO Box 128
3364 State Hwy. 3 N
Wolf Lake, IL 62998-0128
Phone (618) 833-5709

Other names 1

  • Shawnee C U School Other name

National Provider Directory

National Provider Directory
Tax ID family
Shawnee C U School3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1295906030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "address_2": "3364 STATE HWY. 3 N",
            "city": "WOLF LAKE",
            "state": "IL",
            "postal_code": "629980128",
            "telephone_number": "618-833-5709",
            "fax_number": "618-833-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 STATE HWY 3 N",
            "address_2": "3364 STATE HWY 3 N",
            "city": "WOLF LAKE",
            "state": "IL",
            "postal_code": "629980128",
            "telephone_number": "618-833-5709",
            "fax_number": "618-833-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNEE CUSD 84",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SEALS",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "UNIT SECRETARY",
        "authorized_official_telephone_number": "618-833-5709"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shawnee C U School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wolf Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.