Provider Demographics
NPI:1467146100
Name:FVO PRIMARY LLC
Entity Type:Organization
Organization Name:FVO PRIMARY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVIGATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-938-4011
Mailing Address - Street 1:2525 KANEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2578
Mailing Address - Country:US
Mailing Address - Phone:630-584-1400
Mailing Address - Fax:630-584-1733
Practice Address - Street 1:1710 N RANDALL RD STE 140
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-9401
Practice Address - Country:US
Practice Address - Phone:630-584-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOX VALLEY ORTHOPAEDIC ASSOCIATES, S.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care