Fox Valley Adult and Pediatric Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

FOX VALLEY ADULT AND PEDIATRIC MEDICINE PC

Practice address

2020 Dean St. Ste G
St. Charles, IL 60174-1665

Phone

(630) 513-0298

NPI assigned

Jan 3, 2008

Last updated

Mar 31, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Zbigniew Marian Ciechanowski, M.D.NPI 1467452573

Title

Ceo

Phone

(630) 513-0298

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Zbigniew M Ciechanowski, M.D.

  • Internal Medicine Physician
  • St Charles, IL
  • NPI 1467452573
  Medicare reassignment NPD Authorized official
• Arletta Alma De Vries, APRN, FNP-C

  • Nurse Practitioner
  • Mount Prospect, IL
  • NPI 1912350463
  NPD

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1558546952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 DEAN ST. STE G",
            "city": "ST. CHARLES",
            "state": "IL",
            "postal_code": "601741665",
            "telephone_number": "630-513-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 DEAN ST. STE G",
            "city": "ST. CHARLES",
            "state": "IL",
            "postal_code": "601741665",
            "telephone_number": "630-513-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY ADULT AND PEDIATRIC MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "CIECHANOWSKI",
        "authorized_official_first_name": "ZBIGNIEW",
        "authorized_official_middle_name": "MARIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "630-513-0298",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "E94586",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "04532182",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Forst, SLP
• Richard M Forster
• Shona Fowler, PT, DPT
• Fox Prairie Medical Group P C
• Fox River and Countryside Fire Rescue District
• Fox Valley Autism Services, Inc.
• Fox Valley Behavioral Health, S.C.
• Fox Valley Ear, Nose and Throat, Assoc., S.C.
• Fox Valley Medical Supply LLC
• Fox Valley Natural Medicine LLC

• Internal Medicine Physician in St Charles, IL
• Providers in St Charles, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.