Provider Demographics
NPI:1295077337
Name:CENTRAL STICKNEY SD #110
Entity type:Organization
Organization Name:CENTRAL STICKNEY SD #110
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:LEAHY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:708-458-1152
Mailing Address - Street 1:5001 S LANE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-1733
Mailing Address - Country:US
Mailing Address - Phone:708-458-1152
Mailing Address - Fax:708-458-1168
Practice Address - Street 1:5001 LANE AVE.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-1733
Practice Address - Country:US
Practice Address - Phone:708-458-1152
Practice Address - Fax:708-458-1168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)