Provider Demographics
NPI:1124206412
Name:EGYPTIAN COMMUNITY UNIT SCHOOL DISTRICT NO. 5
Entity Type:Organization
Organization Name:EGYPTIAN COMMUNITY UNIT SCHOOL DISTRICT NO. 5
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MISNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-776-5306
Mailing Address - Street 1:20023 DISWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TAMMS
Mailing Address - State:IL
Mailing Address - Zip Code:62988-3234
Mailing Address - Country:US
Mailing Address - Phone:618-776-5306
Mailing Address - Fax:618-776-5122
Practice Address - Street 1:20023 DISWOOD RD
Practice Address - Street 2:
Practice Address - City:TAMMS
Practice Address - State:IL
Practice Address - Zip Code:62988-3234
Practice Address - Country:US
Practice Address - Phone:618-776-5306
Practice Address - Fax:618-776-5122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)