Provider Demographics
NPI:1912015710
Name:PAXTON BUCKLEY LODA COMM UNIT SCHOOL DIST 10
Entity Type:Organization
Organization Name:PAXTON BUCKLEY LODA COMM UNIT SCHOOL DIST 10
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFF
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-379-3314
Mailing Address - Street 1:PANTHER WAY
Mailing Address - Street 2:PO BOX 50
Mailing Address - City:PAXTON
Mailing Address - State:IL
Mailing Address - Zip Code:60957
Mailing Address - Country:US
Mailing Address - Phone:217-379-3314
Mailing Address - Fax:217-379-2862
Practice Address - Street 1:PANTHER WAY
Practice Address - Street 2:
Practice Address - City:PAXTON
Practice Address - State:IL
Practice Address - Zip Code:60957
Practice Address - Country:US
Practice Address - Phone:217-379-3314
Practice Address - Fax:217-379-2862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
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