NPIMap

Organization Active NPI

Associated Pediatrics of Fox Valley, S.C.

  • Specialist
  • Aurora, IL
National Provider Identifier
1407853534
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D42-617396 Issued in IL
Legal business name
ASSOCIATED PEDIATRICS OF FOX VALLEY, S.C.
Practice address
2121 Ridge Ave
Ste 101
Aurora, IL 60504-4273
Phone
(630) 820-7100
Fax
(630) 264-2524
NPI assigned
Jul 5, 2005
Last updated
Dec 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Authorized official

Name
Mrs. Diane M Croft
Title
Office Manager
Phone
(630) 952-2057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D42-617396 IL Primary

Addresses

Primary practice location

2121 Ridge Ave
Ste 101
Aurora, IL 60504-4273

Mailing address

2121 Ridge Ave Ste 101
Aurora, IL 60504-7001
Phone (630) 820-7100

Other identifiers 7

IdentifierTypeStateIssuer
538824101MedicaidIL
036090032MedicaidIL
036114657MedicaidIL
036122395MedicaidIL
036085712MedicaidIL
036040569MedicaidIL
036134476MedicaidIL

National Provider Directory

National Provider Directory

Locations

2121 Ridge Ave
Ste 101
Aurora, IL 60504
Phone (630) 820-7100

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1407853534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 RIDGE AVE STE 101",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047001",
            "telephone_number": "630-820-7100",
            "fax_number": "630-264-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 RIDGE AVE",
            "address_2": "STE 101",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044273",
            "telephone_number": "630-820-7100",
            "fax_number": "630-264-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED PEDIATRICS OF FOX VALLEY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "CROFT",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "630-952-2057",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "D42-617396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "538824101",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090032",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114657",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036122395",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085712",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036040569",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036134476",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.