Provider Demographics
NPI:1710105655
Name:ST ELMO COMMUNITY UNIT SCHOOL DISTRICT
Entity Type:Organization
Organization Name:ST ELMO COMMUNITY UNIT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEB
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILPOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-829-3264
Mailing Address - Street 1:1200 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ELMO
Mailing Address - State:IL
Mailing Address - Zip Code:62458-1368
Mailing Address - Country:US
Mailing Address - Phone:618-829-3264
Mailing Address - Fax:618-829-5161
Practice Address - Street 1:1200 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:SAINT ELMO
Practice Address - State:IL
Practice Address - Zip Code:62458-1368
Practice Address - Country:US
Practice Address - Phone:618-829-3264
Practice Address - Fax:618-829-5161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid