Provider Demographics
NPI:1538297304
Name:EWING-NORTHERN C.C.S.D. # 115
Entity Type:Organization
Organization Name:EWING-NORTHERN C.C.S.D. # 115
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:NIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-629-2181
Mailing Address - Street 1:51 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:IL
Mailing Address - Zip Code:62836-1437
Mailing Address - Country:US
Mailing Address - Phone:618-629-2181
Mailing Address - Fax:618-629-2510
Practice Address - Street 1:51 N MAIN ST
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:IL
Practice Address - Zip Code:62836-1437
Practice Address - Country:US
Practice Address - Phone:618-629-2181
Practice Address - Fax:618-629-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL37600284002251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)