Organization
ILLINOIS CORRECTIONAL INDUSTRIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES UNDERWOOD (CEO)
(217) 522-2666
Entity
Organization
Contact information
Practice address
2600 N BRINTON AVE, DIXON, IL 61021-9532
(815) 288-3010
Mailing address
PO BOX 19277, 1301 CONCORDIA COURT, SPRINGFIELD, IL 62794-9277
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100042652001
—
IL
Enumeration date
04/17/2007
Last updated
07/02/2008
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