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Dongola School Unit Dist 66

Clinic/Center, Student Health in Dongola, IL. Organization (NPI-2).

NPI number1154597698
StatusActive
Last updated in NPPESMay 5, 2008

Details

NPI
1154597698
Entity type
Organization (NPI-2)
Legal business name
Dongola School Unit Dist 66
Organization subpart
No
Enumeration date
May 5, 2008
Last updated
May 5, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QS1000X Clinic/Center, Student Health–ILYes
261Q00000X Clinic/Center–IL

Practice location

1000 High Street
Dongola, IL 62926

Phone 618-827-3841 · Fax 618-827-4641

Mailing address

1000 High Street
Dongola, IL 62926

Phone 618-827-3841 · Fax 618-827-4641

Authorized official

Debra Kay Laster
Bookkeeper
6188273841

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