MEDICARE: ASSOCIATED PEDIATRICS OF FOX VALLEY, S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	D42-617396	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407853534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATED PEDIATRICS OF FOX VALLEY, S.C.

Provider Business Mailing Address
First Line	:	2121 RIDGE AVE STE 101
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-7001
Country	:	US
Telephone Number	:	630-820-7100
Fax Number	:	630-264-2524

Provider Business Practice Location Address
First Line	:	2121 RIDGE AVE
Second Line	:	STE 101
City	:	AURORA
State	:	IL
Zip	:	60504-4273
Country	:	US
Telephone Number	:	630-820-7100
Fax Number	:	630-264-2524

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. DIANE M CROFT
Credential	:
Telephone Number	:	630-952-2057

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	12/10/2014

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Directions to “ASSOCIATED PEDIATRICS OF FOX VALLEY, S.C. ” Practice Location

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