| Shawnee C U School | |
|
3365 State Hwy 3 N 3364 State Hwy 3 N Wolf Lake IL 62998-0128 | |
| (618) 833-5709 | |
| (618) 833-4171 |
| Full Name | Shawnee C U School |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 3365 State Hwy 3 N, Wolf Lake, Illinois |
| Authorized Official Name and Position | Debra L Seals (UNIT SECRETARY) |
| Authorized Official Contact | 6188335709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawnee C U School Po Box 128 3364 State Hwy. 3 N Wolf Lake IL 62998-0128 Ph: (618) 833-5709 | Shawnee C U School 3365 State Hwy 3 N 3364 State Hwy 3 N Wolf Lake IL 62998-0128 Ph: (618) 833-5709 |
| NPI Number | 1295906030 |
|---|---|
| Provider Enumeration Date | 03/20/2008 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295906030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (Illinois) | Primary |
Shawnee Cusd 84 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3365 State Hwy 3 N, 3365 State Hwy 3 N, Wolf Lake, IL 62998 Phone: 618-833-5709 Fax: 618-833-4171 | |
Shawnee C U School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3365 Il Hwy 3n, Wolf Lake, IL 62998 Phone: 618-833-5709 Fax: 618-833-4171 |