MEDICARE: FOX VALLEY NATURAL MEDICINE LLC

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	111N00000X	Chiropractor	038011165	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1700053618	OTHER	IL	INDIVIDUAL NPI FOR RACHAEL ANN FABBI, DC

General Provider Information

NPI Number	:	1437471984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOX VALLEY NATURAL MEDICINE LLC

Provider Business Mailing Address
First Line	:	1831 MOORE CT
Second Line	:
City	:	SAINT CHARLES
State	:	IL
Zip	:	60174-4596
Country	:	US
Telephone Number	:	630-803-8243
Fax Number	:

Provider Business Practice Location Address
First Line	:	1831 MOORE CT
Second Line	:
City	:	SAINT CHARLES
State	:	IL
Zip	:	60174-4596
Country	:	US
Telephone Number	:	630-803-8243
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. RONALD FABBI JR.
Credential	:
Telephone Number	:	630-803-8243

Provider Enumeration Date	:	02/25/2010
Last Update Date	:	02/25/2010

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Directions to “FOX VALLEY NATURAL MEDICINE LLC ” Practice Location

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