Provider Demographics
NPI:1417175530
Name:SPRINGFIELD UNIT 186
Entity Type:Organization
Organization Name:SPRINGFIELD UNIT 186
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-525-3060
Mailing Address - Street 1:900 W EDWARDS ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-1763
Mailing Address - Country:US
Mailing Address - Phone:217-525-3060
Mailing Address - Fax:217-525-3124
Practice Address - Street 1:900 W EDWARDS ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-1763
Practice Address - Country:US
Practice Address - Phone:217-525-3060
Practice Address - Fax:217-525-3124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
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