Provider Demographics
NPI:1245408210
Name:OGLE COUNTY EDUC COOP
Entity Type:Organization
Organization Name:OGLE COUNTY EDUC COOP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-234-2722
Mailing Address - Street 1:417 N COLFAX ST
Mailing Address - Street 2:PO BOX 582
Mailing Address - City:BYRON
Mailing Address - State:IL
Mailing Address - Zip Code:61010-1438
Mailing Address - Country:US
Mailing Address - Phone:815-234-2722
Mailing Address - Fax:
Practice Address - Street 1:417 N COLFAX ST
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:IL
Practice Address - Zip Code:61010-1438
Practice Address - Country:US
Practice Address - Phone:815-234-2722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid