Provider Demographics
NPI:1538389317
Name:BROOKLYN COMMUNITY UNIT SCHOOL DISTRICT
Entity type:Organization
Organization Name:BROOKLYN COMMUNITY UNIT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAELYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-271-1028
Mailing Address - Street 1:800 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:LOVEJOY
Mailing Address - State:IL
Mailing Address - Zip Code:62059
Mailing Address - Country:US
Mailing Address - Phone:618-271-1028
Mailing Address - Fax:618-271-1028
Practice Address - Street 1:800 MADISON ST
Practice Address - Street 2:
Practice Address - City:LOVEJOY
Practice Address - State:IL
Practice Address - Zip Code:62059
Practice Address - Country:US
Practice Address - Phone:618-271-1028
Practice Address - Fax:618-271-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid