Provider Demographics
NPI:1114086683
Name:FOX, JOHN STEPHEN (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:STEPHEN
Last Name:FOX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:151 COPPERWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6804
Mailing Address - Country:US
Mailing Address - Phone:847-478-5150
Mailing Address - Fax:847-478-5150
Practice Address - Street 1:1600 N ARLINGTON HEIGHTS ROAD
Practice Address - Street 2:SUITE 1600
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3908
Practice Address - Country:US
Practice Address - Phone:847-398-1600
Practice Address - Fax:847-398-1611
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223E0200X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223E0200XDental ProvidersDentistEndodontics
Not Answered1223G0001XDental ProvidersDentistGeneral Practice