DESOTO CCSD 86 NPI 1225200850

NPI Information

NPI: 1225200850
Provider Name: DESOTO CCSD 86

Other Name: DESOTO CONS SCHOOL DISTRICXT 86

Classification: Clinic/Center - 261QS1000X
Entity Type: Organization

Specialization: Student Health

Address:
311 HURST RD
DE SOTO, IL
ZIP 62924
Phone: (618) 867-2317
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DESOTO CCSD 86 is a student health clinic center in De Soto, IL. DESOTO CCSD 86 NPI is 1225200850. The provider is registered as an organization entity type.
The provider Other Name Is Desoto Cons School Districxt 86.

The provider's business location address is:

311 HURST RD
DE SOTO, IL
ZIP 62924-228
Phone: (618) 867-2317
Fax: (618) 867-3233

The provider's authorized official is Mark Edward Bullock .
The authorized official title is Superintendent and has the following contact phone number (618) 867-2317.

The enumeration date for this NPI number is 3/24/2008 and was last updated on 4/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QS1000X	Clinic/Center	Student Health		ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========6292401	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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