Organization
JOLIET TWP HS FIST 204
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMAN-ELLIS BOWMAN (DIRECTOR)
(815) 727-6986
Entity
Organization
Contact information
Practice address
201 E JEFFERSON ST, JOLIET, IL 60432-2841
(815) 727-6986
Mailing address
201 E JEFFERSON ST, JOLIET, IL 60432-2841
(815) 727-6986
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
03/02/2007
Last updated
03/14/2016
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