South Fork School Dist #14

Organization Active NPI Case Management Agency · Kincaid, IL

NPI 1659754455 · NPPES record last updated Jun 30, 2015

Key facts

NPI
1659754455
Entity type
Organization (NPI type 2)
Primary specialty
Case Management Agency 251B00000X
Legal business name
SOUTH FORK SCHOOL DIST #14
Practice address
550 Prairie Street
Kincaid, IL 62540-0020
Phone
(217) 237-4331
Fax
(217) 237-2245
NPI assigned
Jun 30, 2015
Organization subpart
No

Authorized official

Name
Wendy Dulakis
Title
Bookkeeper
Phone
(217) 237-4331

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Yes

Addresses

Primary practice location

550 Prairie Street
Kincaid, IL 62540-0020

Mailing address

PO Box 20
Kincaid, IL 62540-0020
Phone (217) 237-4331

Other identifiers

IdentifierTypeStateIssuer
1001101014024MedicaidIL

Other providers in Kincaid, IL

All providers in Kincaid, IL · Case Management Agency in Illinois

Sources for this page

Verify at the official NPI Registry.