Organization
PROVISO TOWNSHIP HIGH SCHOOL DISTRICT 209
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIKITA JOHNSON (ASST SUP FOR FINANCE & OPERATIONS)
(708) 338-5929
Entity
Organization
Contact information
Practice address
8601 ROOSEVELT RD, FOREST PARK, IL 60130-2532
(708) 338-5950
Mailing address
8601 ROOSEVELT RD, FOREST PARK, IL 60130-2532
(708) 338-5950
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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