Pontiac-WM Holliday SD 105

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

PONTIAC-WM HOLLIDAY SD 105

Practice address

400 Ashland Ave
Fairview Heights, IL 62208-2802

Phone

(618) 233-2320

Fax

(618) 233-0918

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Darrell L Sy

Title

Superintendent

Phone

(618) 233-2320

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598804031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ASHLAND AVE",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082802",
            "telephone_number": "618-233-2320",
            "fax_number": "618-233-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ASHLAND AVE",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082802",
            "telephone_number": "618-233-2320",
            "fax_number": "618-233-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTIAC-WM HOLLIDAY SD 105",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SY",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "618-233-2320",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Local Education Agency (LEA) in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Local Education Agency (LEA) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.