WM. W. FOX DEVELOPMENTAL CENTER 1C NPI 1629112503

NPI Information

NPI: 1629112503
Provider Name: WM. W. FOX DEVELOPMENTAL CENTER 1C
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
134 W MAIN ST
DWIGHT, IL
ZIP 60420
Phone: (815) 584-3347
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WM. W. FOX DEVELOPMENTAL CENTER 1C is a residential treatment facility, intellectual and/or developmental disabilities in Dwight, IL. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. WM. W. FOX DEVELOPMENTAL CENTER 1C NPI is 1629112503. The provider is registered as an organization entity type.

The provider's business location address is:

134 W MAIN ST
DWIGHT, IL
ZIP 60420-322
Phone: (815) 584-3347

The provider's authorized official is Gus Pedraza .
The authorized official title is Medical Director and has the following contact phone number (815) 584-3347.

The enumeration date for this NPI number is 2/16/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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