Provider Demographics
NPI:1710094313
Name:OAKLAND COMM UNIT SCHOOL DIST 5
Entity Type:Organization
Organization Name:OAKLAND COMM UNIT SCHOOL DIST 5
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EZRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITHSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-346-2555
Mailing Address - Street 1:PO BOX 200
Mailing Address - Street 2:TEETER STREET
Mailing Address - City:OAKLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61943
Mailing Address - Country:US
Mailing Address - Phone:217-346-2555
Mailing Address - Fax:217-346-2267
Practice Address - Street 1:310 N TEETER STREET
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:IL
Practice Address - Zip Code:61943
Practice Address - Country:US
Practice Address - Phone:217-346-2555
Practice Address - Fax:217-346-2267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
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