SHAWNEE CUSD 84 (NPI# 1669599098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669599098 |
| Entity Type | Organization |
| Organization Name | SHAWNEE CUSD 84 |
| Other Organization Name | SHAWNEE C U SCHOOL |
| Practice Address |
3365 Il Hwy 3n Wolf Lake IL 62998-0128 |
| Mailing Address |
Po Box 128 3365 State Hwy. 3 N Wolf Lake IL 62998-0128 |
| Practice Telephone | 6188335709 |
| Practice Fax Number | 6188334171 |
| Mailing Telephone | 6188335709 |
| Mailing Fax Number | 6188334171 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DEBRA L SEALS (UNIT SECRETARY) |
| Authorized Official Telephone | 61868335709 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Shawnee C U School | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295906030 | Shawnee Cusd 84 | Clinic/Center | 3365 State Hwy 3 N, 3364 State Hwy 3 N, Wolf Lake, IL 62998-0128 | 2008-03-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SHAWNEE CUSD 84 | 3365 State Route 3 North, Wolf Lake, IL 62998-1157 |
| Street Address |
3365 IL HWY 3N |
| City | WOLF LAKE |
| State | IL |
| Zip Code | 62998-0128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265950968 | Kaleigh Noel Zeigler | Speech-Language Pathologist | 3365 State Highway 3 North, Wolf Lake, IL 62998 | 2017-09-01 |
| 1295906030 | Shawnee Cusd 84 | Clinic/Center | 3365 State Hwy 3 N, 3364 State Hwy 3 N, Wolf Lake, IL 62998-0128 | 2008-03-20 |
| 1164696639 | Shawnee C U School | Clinic/Center | 3365 State Hwy 3 N, 3365 State Hwy 3 N, Wolf Lake, IL 62998-0128 | 2008-04-16 |
| 1740414986 | Poe's Transit | Secured Medical Transport (VAN) | 40 Lakeview St, Wolf Lake, IL 62998-1000 | 2009-05-01 |
| 1922363290 | Diana Elizabeth Poole | Respiratory Therapist, Registered | 9035 Main St, Wolf Lake, IL 62998-1057 | 2012-07-11 |
| 1205174638 | Southern Rehab Works, Ltd | Clinic/Center | 580 Hoot Owl Ln, Wolf Lake, IL 62998-1137 | 2013-01-18 |
| 1932618915 | Kimberly Ann Warren | Registered Nurse | 3365 N State Route 3, Wolf Lake, IL 62998-1157 | 2017-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932618915 | Kimberly Ann Warren | Registered Nurse | 3365 N State Route 3, Wolf Lake, IL 62998-1157 | 2017-09-22 |
| 1265950968 | Kaleigh Noel Zeigler | Speech-Language Pathologist | 3365 State Highway 3 North, Wolf Lake, IL 62998 | 2017-09-01 |
| 1205174638 | Southern Rehab Works, Ltd | Clinic/Center | 580 Hoot Owl Ln, Wolf Lake, IL 62998-1137 | 2013-01-18 |
| 1922363290 | Diana Elizabeth Poole | Respiratory Therapist, Registered | 9035 Main St, Wolf Lake, IL 62998-1057 | 2012-07-11 |
| 1740414986 | Poe's Transit | Secured Medical Transport (VAN) | 40 Lakeview St, Wolf Lake, IL 62998-1000 | 2009-05-01 |
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295906030 | Shawnee Cusd 84 | Clinic/Center | 3365 State Hwy 3 N, 3364 State Hwy 3 N, Wolf Lake, IL 62998-0128 | 2008-03-20 |
| 1164696639 | Shawnee C U School | Clinic/Center | 3365 State Hwy 3 N, 3365 State Hwy 3 N, Wolf Lake, IL 62998-0128 | 2008-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811409196 | Gavin School District 37 | Clinic/Center | 25775 W Highway 134, Ingleside, IL 60041-9587 | 2017-10-26 |
| 1053822080 | Northestern Illinois University Student Health Services | Clinic/Center | 5500 N Saint Louis Ave Rm E-051, Chicago, IL 60625-4625 | 2017-10-17 |
| 1871905190 | The Board of Trustees of The University of Illinois | Clinic/Center | 840 Blackhawk Blvd, South Beloit, IL 61080-2263 | 2014-05-21 |
| 1043630098 | Mcgaw Medical Center of Northwestern University | Clinic/Center | 240 E. Huron Street, Mcgaw Pavilion, Sutie 1-200, Chicago, IL 60611 | 2014-04-17 |
| 1407284664 | Pef Clinic II, Ltd. | Clinic/Center | 1955 E 75th St, Chicago, IL 60649-3688 | 2013-10-28 |
| 1508294091 | South Shore School of Leadership Health Center | Clinic/Center | 7627 S Constance Ave, Chicago, IL 60649-4009 | 2013-10-22 |
| 1659705150 | Circle Family Healthcare Network | Clinic/Center | 4701 Harrison St, Hillside, IL 60162-1616 | 2013-09-03 |
| 1932441946 | The Board of Trustees of Siu Governing Siue | Clinic/Center | Student Success Ctr Rm 0222, Campus Box 1055, Edwardsville, IL 62026-1055 | 2013-03-18 |
| 1225378094 | Kankakee School District 111 | Clinic/Center | 1200 W Jeffery St, Kankakee, IL 60901-4667 | 2013-02-15 |
| 1033478383 | Rockford School District | Clinic/Center | 401 N Gardiner Ave, Rockford, IL 61107-4338 | 2012-05-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.