Provider Demographics
NPI:1609906031
Name:ANTIOCH COMMUNITY HS DIST 117
Entity Type:Organization
Organization Name:ANTIOCH COMMUNITY HS DIST 117
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:FRICHTL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-838-7115
Mailing Address - Street 1:1133 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:IL
Mailing Address - Zip Code:60002-1807
Mailing Address - Country:US
Mailing Address - Phone:847-838-7639
Mailing Address - Fax:847-395-2435
Practice Address - Street 1:1133 MAIN ST
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:IL
Practice Address - Zip Code:60002-1807
Practice Address - Country:US
Practice Address - Phone:847-838-7115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)