Organization
MERIDIAN CUSD 223
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ORTGIESEN (MEDICAID ADMIN)
(815) 645-4325
Entity
Organization
Contact information
Practice address
425 S PINE ST, STILLMAN VALLEY, IL 61084-8943
(815) 645-4325
Mailing address
425 S PINE ST, STILLMAN VALLEY, IL 61084-8943
(815) 645-4325
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
02/13/2008
Last updated
04/20/2008
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