Provider Demographics
NPI:1710159991
Name:OAK GROVE SCHOOL DISTRICT 68
Entity Type:Organization
Organization Name:OAK GROVE SCHOOL DISTRICT 68
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:SULLIVAN
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-996-1403
Mailing Address - Street 1:1700 S O'PLAINE ROAD
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1541
Mailing Address - Country:US
Mailing Address - Phone:847-367-4120
Mailing Address - Fax:
Practice Address - Street 1:1700 S O'PLAINE ROAD
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-1541
Practice Address - Country:US
Practice Address - Phone:847-367-4120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001OtherHFS