Provider Demographics
NPI:1801949060
Name:NEWARK GRADE SCHOOL #66
Entity type:Organization
Organization Name:NEWARK GRADE SCHOOL #66
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-695-5143
Mailing Address - Street 1:503 CHICAGO RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:IL
Mailing Address - Zip Code:60541-9501
Mailing Address - Country:US
Mailing Address - Phone:815-695-5143
Mailing Address - Fax:815-695-5776
Practice Address - Street 1:503 CHICAGO RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:IL
Practice Address - Zip Code:60541-9501
Practice Address - Country:US
Practice Address - Phone:815-695-5143
Practice Address - Fax:815-695-5776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid