NPIMap

Organization Active NPI

Fox Valley Institute for Growth and Wellness Inc

  • Counselor
  • Naperville, IL
National Provider Identifier
1174637334
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
00000000 Issued in IL
Legal business name
FOX VALLEY INSTITUTE FOR GROWTH AND WELLNESS INC
Practice address
640 N River Rd
Suite 108
Naperville, IL 60563-8949
Phone
(630) 718-0717
Fax
(630) 718-0747
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Laura Lynn Bokar, ED.D, LCPC, LMFTNPI 1134233430
Title
Owner
Phone
(630) 718-0717

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 00000000 IL Primary

Addresses

Primary practice location

640 N River Rd
Suite 108
Naperville, IL 60563-8949

Mailing address

640 N River Rd Ste 108
Naperville, IL 60563-8947
Phone (630) 718-0717

Other identifiers 1

IdentifierTypeStateIssuer
0002225381OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050318000054 IL Part B Supplier - Clinic/Group Practice 0244285617 Receives reassigned benefits from 22 practitioners
Practice locations: Naperville, IL

National Provider Directory

National Provider Directory

Locations

636 Raymond Dr
Ste 305
Naperville, IL 60563
Phone (630) 718-0717

Practitioners & affiliated clinicians

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 49

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557446400000",
    "number": "1174637334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 N RIVER RD STE 108",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638947",
            "telephone_number": "630-718-0717",
            "fax_number": "630-718-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N RIVER RD",
            "address_2": "SUITE 108",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638949",
            "telephone_number": "630-718-0717",
            "fax_number": "630-718-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY INSTITUTE FOR GROWTH AND WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2019-05-10",
        "status": "A",
        "authorized_official_last_name": "BOKAR",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-718-0717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D, LCPC, LMFT"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "IL",
            "license": "00000000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0002225381",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.