Provider Demographics
NPI:1790199008
Name:FOX VALLEY SPECIAL CONSULTATIONS
Entity Type:Organization
Organization Name:FOX VALLEY SPECIAL CONSULTATIONS
Other - Org Name:CARE CLINICS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROCUSH
Authorized Official - Suffix:
Authorized Official - Credentials:BSW, CADC
Authorized Official - Phone:630-896-4650
Mailing Address - Street 1:522 N LAKE ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-3105
Mailing Address - Country:US
Mailing Address - Phone:630-896-4650
Mailing Address - Fax:630-896-9367
Practice Address - Street 1:522 N LAKE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-3105
Practice Address - Country:US
Practice Address - Phone:630-896-4650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-1222-0003-A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health