| Organization Name: | INDIAN SPRINGS SCH DIST 109 |
| NPI Number: | 1497889687 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LINDA JEFFERS (MANAGER) |
| Mailing Address: | 7540 South 86th Ave Justice |
| State: | IL US |
| Postal Code: | 60458 |
| Phone Number: | 7084968700 |
| Fax Number: | 7084968641 |
| NPI Enumeration Date: | 03/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Student Health |
| Taxonomy Definition: | |