Provider Demographics
NPI:1578657086
Name:CISSNA PARK COMMUNITY UNIT SCHOOL DISTRICT # 6
Entity Type:Organization
Organization Name:CISSNA PARK COMMUNITY UNIT SCHOOL DISTRICT # 6
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-457-2171
Mailing Address - Street 1:511 NORTH 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:CISSNA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60924
Mailing Address - Country:US
Mailing Address - Phone:815-457-2171
Mailing Address - Fax:815-457-3033
Practice Address - Street 1:511 NORTH 2ND STREET
Practice Address - Street 2:
Practice Address - City:CISSNA PARK
Practice Address - State:IL
Practice Address - Zip Code:60924
Practice Address - Country:US
Practice Address - Phone:815-457-2171
Practice Address - Fax:815-457-3033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
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