NPIMap

Organization Active NPI

Fox Valley Physician Services SC

  • Internal Medicine Physician
  • North Aurora, IL
National Provider Identifier
1508071457
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FOX VALLEY PHYSICIAN SERVICES SC
Practice address
23 N Lincolnway
North Aurora, IL 60506-1635
Phone
(630) 966-2637
Fax
(630) 966-1611
NPI assigned
May 14, 2007
Last updated
Sep 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Authorized official

Name
Dr. Robert W Boer, DC PACNPI 1649390014
Title
Owner
Phone
(630) 966-2637

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Chiropractor 111N00000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

23 N Lincolnway
North Aurora, IL 60506-1635

Mailing address

23 N Lincolnway
North Aurora, IL 60506-1635
Phone (630) 966-2637

Other identifiers 1

IdentifierTypeStateIssuer
4532434OtherILBCBS

National Provider Directory

National Provider Directory

Locations

888 S Route 59
Ste 140
Naperville, IL 60540
Phone (630) 357-8700

23 N Lincolnway
North Aurora, IL 60542
Phone (630) 966-2637

Practitioners & affiliated clinicians

Practitioners 11

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": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1508071457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 N LINCOLNWAY",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605061635",
            "telephone_number": "630-966-2637",
            "fax_number": "630-966-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 N LINCOLNWAY",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605061635",
            "telephone_number": "630-966-2637",
            "fax_number": "630-966-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY PHYSICIAN SERVICES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "BOER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-966-2637",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC PAC"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4532434",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; 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.