Provider Demographics
NPI:1497889687
Name:INDIAN SPRINGS SCH DIST 109
Entity Type:Organization
Organization Name:INDIAN SPRINGS SCH DIST 109
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-496-8700
Mailing Address - Street 1:7540 SOUTH 86TH AVE
Mailing Address - Street 2:
Mailing Address - City:JUSTICE
Mailing Address - State:IL
Mailing Address - Zip Code:60458
Mailing Address - Country:US
Mailing Address - Phone:708-496-8700
Mailing Address - Fax:708-496-8641
Practice Address - Street 1:7540 SOUTH 86TH AVE
Practice Address - Street 2:
Practice Address - City:JUSTICE
Practice Address - State:IL
Practice Address - Zip Code:60458
Practice Address - Country:US
Practice Address - Phone:708-496-8700
Practice Address - Fax:708-496-8641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health