Provider Demographics
NPI:1760608467
Name:MAINE TOWNSHIP SPECIAL EDUCATION PROGRAM
Entity Type:Organization
Organization Name:MAINE TOWNSHIP SPECIAL EDUCATION PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VISION COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-966-2911
Mailing Address - Street 1:8901 N OZANAM AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1711
Mailing Address - Country:US
Mailing Address - Phone:847-966-2911
Mailing Address - Fax:847-966-8268
Practice Address - Street 1:8901 N OZANAM AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1711
Practice Address - Country:US
Practice Address - Phone:847-966-2911
Practice Address - Fax:847-966-8268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)