Provider Demographics
NPI:1730306523
Name:MURPHYSBORO CU SCH DIST 186
Entity Type:Organization
Organization Name:MURPHYSBORO CU SCH DIST 186
Other - Org Name:COMM UNIT SCHOOL DIST 186
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-684-3781
Mailing Address - Street 1:819 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MURPHYSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62966-2126
Mailing Address - Country:US
Mailing Address - Phone:618-684-3781
Mailing Address - Fax:618-684-2465
Practice Address - Street 1:819 WALNUT ST
Practice Address - Street 2:
Practice Address - City:MURPHYSBORO
Practice Address - State:IL
Practice Address - Zip Code:62966-2126
Practice Address - Country:US
Practice Address - Phone:618-684-3781
Practice Address - Fax:618-684-2465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid