Provider Demographics
NPI:1508034570
Name:ORANGEVILLE CUSD 203
Entity Type:Organization
Organization Name:ORANGEVILLE CUSD 203
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-789-4450
Mailing Address - Street 1:310 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:ORANGEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61060-9231
Mailing Address - Country:US
Mailing Address - Phone:715-789-4450
Mailing Address - Fax:
Practice Address - Street 1:310 S EAST ST
Practice Address - Street 2:
Practice Address - City:ORANGEVILLE
Practice Address - State:IL
Practice Address - Zip Code:61060-9231
Practice Address - Country:US
Practice Address - Phone:715-789-4450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL366005476001Medicaid