Provider Demographics
NPI:1144358185
Name:FIELD COMMUNITY CONSOLIDATED SCHOOL
Entity type:Organization
Organization Name:FIELD COMMUNITY CONSOLIDATED SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:ILBERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-755-4611
Mailing Address - Street 1:21075 N HAILS LN
Mailing Address - Street 2:
Mailing Address - City:TEXICO
Mailing Address - State:IL
Mailing Address - Zip Code:62889-2932
Mailing Address - Country:US
Mailing Address - Phone:618-755-4611
Mailing Address - Fax:618-755-9701
Practice Address - Street 1:21075 N HAILS LN
Practice Address - Street 2:
Practice Address - City:TEXICO
Practice Address - State:IL
Practice Address - Zip Code:62889-2932
Practice Address - Country:US
Practice Address - Phone:618-755-4611
Practice Address - Fax:618-755-9701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376003399002251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL250410030040000OtherRCDT CODE