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WM. W. Fox Developmental Center 1C

Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Dwight, IL

NPI 1629112503 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1629112503
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Legal business name
WM. W. FOX DEVELOPMENTAL CENTER 1C
Practice address
134 W Main St
Dwight, IL 60420-1322
Phone
(815) 584-3347
NPI assigned
Feb 16, 2007
Organization subpart
No

Authorized official

Name
Dr. Gus Pedraza
Title
Medical Director
Phone
(815) 584-3347

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Howe Center - Unit 4264 (292 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes

Addresses

Primary practice location

134 W Main St
Dwight, IL 60420-1322

Mailing address

134 W Main St
Dwight, IL 60420-1322
Phone (815) 584-3347

Other providers in Dwight, IL

All providers in Dwight, IL · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Illinois

Sources for this page

Verify at the official NPI Registry.