| Fox Valley Neurology Pc | |
|
860 Summit St Ste 254 Elgin IL 60120-4339 | |
| (847) 695-8721 | |
| (847) 695-8755 |
| Full Name | Fox Valley Neurology Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 860 Summit St, Elgin, Illinois |
| Authorized Official Name and Position | Wayne R Gavino (PRESIDENT) |
| Authorized Official Contact | 8476958721 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fox Valley Neurology Pc 860 Summit St Ste 254 Elgin IL 60120-4339 Ph: (847) 695-8721 | Fox Valley Neurology Pc 860 Summit St Ste 254 Elgin IL 60120-4339 Ph: (847) 695-8721 |
| NPI Number | 1760416762 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 11/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760416762 | NPI | - | NPPES |
| 1615763 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 060000735 (Illinois) | Primary |
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