Provider Demographics
NPI:1770634057
Name:FOX, JAMIE CHRISTINE (MA)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:CHRISTINE
Last Name:FOX
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 EAGLE RDG
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60081-8508
Mailing Address - Country:US
Mailing Address - Phone:630-542-1084
Mailing Address - Fax:
Practice Address - Street 1:15 COMMERCE DR
Practice Address - Street 2:SUITE 116
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-7807
Practice Address - Country:US
Practice Address - Phone:847-223-7433
Practice Address - Fax:847-223-7435
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL12083323235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist