Provider Demographics
NPI:1265556369
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:VICE PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:LILA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:HONEY
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:630-584-3301
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:630-584-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center