Provider Demographics
NPI:1790962173
Name:CYPRESS ELEM. SCHOOL DIST. #64
Entity Type:Organization
Organization Name:CYPRESS ELEM. SCHOOL DIST. #64
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/BOOKKEEPER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-657-2525
Mailing Address - Street 1:PO BOX 109
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:IL
Mailing Address - Zip Code:62923-0109
Mailing Address - Country:US
Mailing Address - Phone:618-657-2525
Mailing Address - Fax:618-657-2570
Practice Address - Street 1:4580 MOUNT PISGAH RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:IL
Practice Address - Zip Code:62923-2139
Practice Address - Country:US
Practice Address - Phone:618-657-2525
Practice Address - Fax:618-657-2570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL64OtherSCHOOL