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General NPI Number Information
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NPI Number | 1518014778
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Entity Type | Organization
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Legal Business Name | FOX VALLEY IMAGING CENTER, INC.
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 03/23/2012
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Provider Practice Location Address
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Address Line | 1971 GOWDEY RD SUITE 107
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City | NAPERVILLE
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State | IL
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Zip | 60563-4232
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Country | US
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Telephone | 630-416-1300
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Fax | 630-416-1511
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Provider Business Mailing Address
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Address Line | 1971 GOWDEY RD SUITE 107
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City | NAPERVILLE
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State | IL
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Zip | 60563-4232
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Country | US
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Telephone | 630-416-1300
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Fax | 630-416-1511
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MR. STEVEN A. DAGHFAL
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Credential |
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Telephone | 630-416-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 9251598
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License Number State | IL
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