Organization
SHAWNEE CUSD 84
Active
Other names
Shawnee C U School
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA L SEALS (UNIT SECRETARY)
61868335709
Entity
Organization
Contact information
Practice address
3365 IL HWY 3N, WOLF LAKE, IL 62998-0128
(618) 833-5709
(618) 833-4171
Mailing address
PO BOX 128, 3365 STATE HWY. 3 N, WOLF LAKE, IL 62998-0128
(618) 833-5709
(618) 833-4171
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
IL
Other
Enumeration date
03/22/2007
Last updated
08/22/2020
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