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General NPI Number Information
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NPI Number | 1093025496
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Entity Type | Organization
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Legal Business Name | FOX VALLEY NEW YOU, INC
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 1795 W STATE ST STE D
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City | GENEVA
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State | IL
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Zip | 60134-4709
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Country | US
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Telephone | 630-232-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 1795 W STATE ST STE D
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City | GENEVA
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State | IL
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Zip | 60134-4709
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVE GINSBERG
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Credential | D.C.
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Telephone | 630-232-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 038-006842
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License Number State | IL
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