NPIMap

Organization Active NPI

Fox Valley Immediate Care Center, LTD

  • Family Medicine Physician
  • East Dundee, IL
National Provider Identifier
1780908178
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FOX VALLEY IMMEDIATE CARE CENTER, LTD
Practice address
151 Dundee Ave
Suite C
East Dundee, IL 60118-1648
Phone
(847) 426-9396
Fax
(847) 426-1086
NPI assigned
Mar 15, 2010
Last updated
Aug 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Authorized official

Name
Dr. Carmen Tuemgne Fotso, MD
Title
Owner
Phone
(847) 909-2590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

151 Dundee Ave
Suite C
East Dundee, IL 60118-1648

Mailing address

151 Dundee Ave
Suite C
East Dundee, IL 60118-1648
Phone (847) 426-9396

National Provider Directory

National Provider Directory

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": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1780908178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 DUNDEE AVE",
            "address_2": "SUITE C",
            "city": "EAST DUNDEE",
            "state": "IL",
            "postal_code": "601181648",
            "telephone_number": "847-426-9396",
            "fax_number": "847-426-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 DUNDEE AVE",
            "address_2": "SUITE C",
            "city": "EAST DUNDEE",
            "state": "IL",
            "postal_code": "601181648",
            "telephone_number": "847-426-9396",
            "fax_number": "847-426-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY IMMEDIATE CARE CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "FOTSO",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "TUEMGNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-909-2590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Dundee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.