Provider Demographics
NPI:1821105834
Name:ARMSTRONG ELLIS CSD 61
Entity Type:Organization
Organization Name:ARMSTRONG ELLIS CSD 61
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCARLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-569-2115
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:3571 GIFFORD
Mailing Address - City:ARMSTRONG
Mailing Address - State:IL
Mailing Address - Zip Code:61812-0007
Mailing Address - Country:US
Mailing Address - Phone:217-569-2115
Mailing Address - Fax:
Practice Address - Street 1:3571 GIFFORD
Practice Address - Street 2:
Practice Address - City:ARMSTRONG
Practice Address - State:IL
Practice Address - Zip Code:61812-0007
Practice Address - Country:US
Practice Address - Phone:217-569-2115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Not Answered251300000XAgenciesLocal Education Agency (LEA)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid