Provider Demographics
NPI:1437471984
Name:FOX VALLEY NATURAL MEDICINE LLC
Entity Type:Organization
Organization Name:FOX VALLEY NATURAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:FABBI
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:630-803-8243
Mailing Address - Street 1:1831 MOORE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-4596
Mailing Address - Country:US
Mailing Address - Phone:630-803-8243
Mailing Address - Fax:
Practice Address - Street 1:1831 MOORE CT
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-4596
Practice Address - Country:US
Practice Address - Phone:630-803-8243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1700053618OtherINDIVIDUAL NPI FOR RACHAEL ANN FABBI, DC