Fox Valley Neurology PC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

060000735 Issued in IL

Legal business name

FOX VALLEY NEUROLOGY PC

Practice address

860 Summit St
Ste 254
Elgin, IL 60120-4339

Phone

(847) 695-8721

Fax

(847) 695-8755

NPI assigned

Jul 10, 2006

Organization subpart

No

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

Authorized official

Name

Wayne R Gavino, MD

Title

President

Phone

(847) 695-8721

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Conchita G Gavino, MD

  • Psychiatry Physician
  • Elgin, IL
  • NPI 1215961214
  NPD

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354233600000",
    "number": "1760416762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 SUMMIT ST",
            "address_2": "STE 254",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601204339",
            "telephone_number": "847-695-8721",
            "fax_number": "847-695-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 SUMMIT ST",
            "address_2": "STE 254",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601204339",
            "telephone_number": "847-695-8721",
            "fax_number": "847-695-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY NEUROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-11-30",
        "status": "A",
        "authorized_official_last_name": "GAVINO",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-695-8721",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "060000735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1615763",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fox Valley Chiropractic Clinic, LTD
• Fox Valley Comprehensive Womens Healthcare PC
• Fox Valley Dental Group
• Fox Valley Hematology, Inc
• Fox Valley Laboratory Physicians SC
• Fox Valley Orthopaedic Associates, PLLC
• Fox Valley Orthopaedic Associates, PLLC
• Fox Valley Orthopaedic Associates, PLLC
• Fox Valley Orthopaedic Associates, S.C.
• Fox Valley Pain Center S.C.

• Neurology Physician in Elgin, IL
• Providers in Elgin, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.