Provider Demographics
NPI:1730235102
Name:COMMUNITY UNIT SCHOOL DIST 4
Entity type:Organization
Organization Name:COMMUNITY UNIT SCHOOL DIST 4
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERKER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:309-473-3727
Mailing Address - Street 1:522 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HEYWORTH
Mailing Address - State:IL
Mailing Address - Zip Code:61745-9694
Mailing Address - Country:US
Mailing Address - Phone:309-473-3727
Mailing Address - Fax:309-473-2220
Practice Address - Street 1:522 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HEYWORTH
Practice Address - State:IL
Practice Address - Zip Code:61745-9694
Practice Address - Country:US
Practice Address - Phone:309-473-3727
Practice Address - Fax:309-473-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2022-07-21
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