Provider Demographics
NPI:1225154685
Name:FRANKLIN PARK SCHOOL DISTRICT 84
Entity Type:Organization
Organization Name:FRANKLIN PARK SCHOOL DISTRICT 84
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEMEC
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:847-455-4230
Mailing Address - Street 1:2915 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60131-3031
Mailing Address - Country:US
Mailing Address - Phone:847-455-4230
Mailing Address - Fax:
Practice Address - Street 1:2915 MAPLE ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-3031
Practice Address - Country:US
Practice Address - Phone:847-455-4230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid