Provider Demographics
NPI:1912031741
Name:COMMUNITY UNIT DISTRICT #3
Entity Type:Organization
Organization Name:COMMUNITY UNIT DISTRICT #3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:NORTHRUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-586-4947
Mailing Address - Street 1:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:MAHEMET
Mailing Address - State:IL
Mailing Address - Zip Code:61853-0229
Mailing Address - Country:US
Mailing Address - Phone:217-586-4947
Mailing Address - Fax:217-586-7591
Practice Address - Street 1:101 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:MAHEMET
Practice Address - State:IL
Practice Address - Zip Code:61853-0229
Practice Address - Country:US
Practice Address - Phone:217-586-4947
Practice Address - Fax:217-586-7591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL37600259001Medicaid