Provider Demographics
NPI:1740652239
Name:LEARN 9 CAMPUS IN WAUKEGAN
Entity type:Organization
Organization Name:LEARN 9 CAMPUS IN WAUKEGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-720-6696
Mailing Address - Street 1:540 S MCALISTER AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-6461
Mailing Address - Country:US
Mailing Address - Phone:312-343-2855
Mailing Address - Fax:
Practice Address - Street 1:540 S MCALISTER AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-6461
Practice Address - Country:US
Practice Address - Phone:312-343-2855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)