Healthcare Provider Details
I. General information
NPI: 1003746454
Provider Name (Legal Business Name): SURGERY CENTER OF THE FOX VALLEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1540 LYON DR STE 2
NEENAH WI
54956-5037
US
IV. Provider business mailing address
1540 LYON DR STE 2
NEENAH WI
54956-5037
US
V. Phone/Fax
- Phone: 862-668-8888
- Fax:
- Phone: 862-668-8888
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
VISHAL
M
PATEL
Title or Position: OWNER, PARTNER
Credential: MD
Phone: 862-668-8888