Provider Demographics
NPI:1053597948
Name:PEORIA SCHOOL DIST 150
Entity type:Organization
Organization Name:PEORIA SCHOOL DIST 150
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-282-0876
Mailing Address - Street 1:919 S MATTHEW ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61605-3576
Mailing Address - Country:US
Mailing Address - Phone:309-282-0876
Mailing Address - Fax:309-282-0885
Practice Address - Street 1:919 S MATTHEW ST
Practice Address - Street 2:SUITE 210
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61605-3576
Practice Address - Country:US
Practice Address - Phone:309-282-0876
Practice Address - Fax:309-282-0885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)