Provider Demographics
NPI:1194831917
Name:IROQUOIS COUNTY CUSD 9
Entity Type:Organization
Organization Name:IROQUOIS COUNTY CUSD 9
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BIANCHETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-432-4931
Mailing Address - Street 1:109 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WATSEKA
Mailing Address - State:IL
Mailing Address - Zip Code:60970-1508
Mailing Address - Country:US
Mailing Address - Phone:815-432-4931
Mailing Address - Fax:815-432-6889
Practice Address - Street 1:109 S 2ND ST
Practice Address - Street 2:
Practice Address - City:WATSEKA
Practice Address - State:IL
Practice Address - Zip Code:60970-1508
Practice Address - Country:US
Practice Address - Phone:815-432-4931
Practice Address - Fax:815-432-6889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid