Provider Demographics
NPI:1659403582
Name:KILDEER COUNTRYSIDE CCSD96
Entity Type:Organization
Organization Name:KILDEER COUNTRYSIDE CCSD96
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIZIELLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-459-4260
Mailing Address - Street 1:1050 IVY HALL LN
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1333
Mailing Address - Country:US
Mailing Address - Phone:847-459-4260
Mailing Address - Fax:847-459-2344
Practice Address - Street 1:1050 IVY HALL LN
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1333
Practice Address - Country:US
Practice Address - Phone:847-459-4260
Practice Address - Fax:847-459-2344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)