Provider Demographics
NPI:1619073145
Name:FOX, JOHN THORNTON (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:THORNTON
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:500 N HICKS RD
Mailing Address - Street 2:STE 100
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-3647
Mailing Address - Country:US
Mailing Address - Phone:847-221-8700
Mailing Address - Fax:847-991-9348
Practice Address - Street 1:500 N HICKS RD
Practice Address - Street 2:STE 100
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-3647
Practice Address - Country:US
Practice Address - Phone:847-221-8700
Practice Address - Fax:847-991-9348
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036064952207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
036064952OtherIL STATE MED LICENSE
AF1998366OtherDEA NUMBER
036064952OtherIL STATE MED LICENSE
AF1998366OtherDEA NUMBER