Provider Demographics
NPI:1336336213
Name:FOX VALLEY HEALTH & REHABILITATION, S.C
Entity Type:Organization
Organization Name:FOX VALLEY HEALTH & REHABILITATION, S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SEXTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-882-8909
Mailing Address - Street 1:200 GARDEN ST
Mailing Address - Street 2:BLDG A UNIT D
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-8920
Mailing Address - Country:US
Mailing Address - Phone:630-882-8909
Mailing Address - Fax:630-882-8906
Practice Address - Street 1:200 GARDEN ST
Practice Address - Street 2:BLDG A UNIT D
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-8920
Practice Address - Country:US
Practice Address - Phone:630-882-8909
Practice Address - Fax:630-882-8906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty