Provider Demographics
NPI:1639371107
Name:OHIO COMM CONS SCHOOL DIST 17
Entity Type:Organization
Organization Name:OHIO COMM CONS SCHOOL DIST 17
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-875-2645
Mailing Address - Street 1:103 MEMORIAL
Mailing Address - Street 2:
Mailing Address - City:OHIO
Mailing Address - State:IL
Mailing Address - Zip Code:61349-0478
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:103 MEMORIAL
Practice Address - Street 2:
Practice Address - City:OHIO
Practice Address - State:IL
Practice Address - Zip Code:61349-0478
Practice Address - Country:US
Practice Address - Phone:815-875-2645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)