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General NPI Number Information
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NPI Number | 1407853534
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Entity Type | Organization
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Legal Business Name | ASSOCIATED PEDIATRICS OF FOX VALLEY, S.C.
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 12/10/2014
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Provider Practice Location Address
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Address Line | 2121 RIDGE AVE STE 101
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City | AURORA
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State | IL
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Zip | 60504-4273
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Country | US
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Telephone | 630-820-7100
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Fax | 630-264-2524
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Provider Business Mailing Address
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Address Line | 2121 RIDGE AVE STE 101
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City | AURORA
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State | IL
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Zip | 60504-7001
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Country | US
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Telephone | 630-820-7100
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Fax | 630-264-2524
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DIANE M CROFT
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Credential |
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Telephone | 630-952-2057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D42-617396
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License Number State | IL
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