Provider Demographics
NPI:1679684674
Name:EFFINGHAM COMMUNITY UNIT SCHOOL DIST 40
Entity Type:Organization
Organization Name:EFFINGHAM COMMUNITY UNIT SCHOOL DIST 40
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLASBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-540-1500
Mailing Address - Street 1:2803 S BANKER ST
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-2978
Mailing Address - Country:US
Mailing Address - Phone:217-540-1500
Mailing Address - Fax:217-540-1510
Practice Address - Street 1:2803 S BANKER ST
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-2978
Practice Address - Country:US
Practice Address - Phone:217-540-1500
Practice Address - Fax:217-540-1510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
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