Provider Demographics
NPI:1902942238
Name:HINSDALE TOWNSHIP HIGH SCHOOL DISTRICT 86
Entity Type:Organization
Organization Name:HINSDALE TOWNSHIP HIGH SCHOOL DISTRICT 86
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SUPT. FOR BUSINESS
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-655-6100
Mailing Address - Street 1:55TH AND GRANT STREETS
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521
Mailing Address - Country:US
Mailing Address - Phone:630-655-6100
Mailing Address - Fax:
Practice Address - Street 1:55TH AND GRANT STREETS
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521
Practice Address - Country:US
Practice Address - Phone:630-655-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid