Provider Demographics
NPI:1598834368
Name:FOX VALLEY WELLNESS CENTER, LTD
Entity Type:Organization
Organization Name:FOX VALLEY WELLNESS CENTER, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEN
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY LOU
Authorized Official - Middle Name:
Authorized Official - Last Name:SAXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-584-3999
Mailing Address - Street 1:2325 DEAN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-4810
Mailing Address - Country:US
Mailing Address - Phone:630-584-3999
Mailing Address - Fax:630-584-3999
Practice Address - Street 1:2325 DEAN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-4810
Practice Address - Country:US
Practice Address - Phone:630-584-3999
Practice Address - Fax:630-584-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty