Provider Demographics
NPI:1114247632
Name:FOX VALLEY MEDICAL DIAGNOSTIC SERVICES INC.
Entity Type:Organization
Organization Name:FOX VALLEY MEDICAL DIAGNOSTIC SERVICES INC.
Other - Org Name:FOX VALLEY SLEEP MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZAINULABUDDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-820-8586
Mailing Address - Street 1:3535 E NEW YORK STREET
Mailing Address - Street 2:SUITE 118
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4466
Mailing Address - Country:US
Mailing Address - Phone:630-820-8586
Mailing Address - Fax:630-820-8589
Practice Address - Street 1:3535 E NEW YORK STREET
Practice Address - Street 2:SUITE 118
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4466
Practice Address - Country:US
Practice Address - Phone:630-820-8586
Practice Address - Fax:630-820-8589
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOX VALLEY MEDICAL DIAGNOSTIC SV
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-07
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL4536Medicare PIN