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General NPI Number Information
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NPI Number | 1083628994
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Entity Type | Organization
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Legal Business Name | FOX VALLEY CHILDREN'S MEDICINE, S.C.
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1180 W WILSON ST SUITE B
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City | BATAVIA
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State | IL
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Zip | 60510-7611
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Country | US
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Telephone | 630-208-3961
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Fax | 630-208-3970
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Provider Business Mailing Address
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Address Line | 1180 W WILSON ST SUITE B
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City | BATAVIA
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State | IL
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Zip | 60510-7611
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Country | US
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Telephone | 630-208-3961
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Fax | 630-208-3970
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL JAY SCHULMAN
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Credential | M.D.
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Telephone | 630-208-3961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | IL
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