Fox River Pavilion Limited Partnership

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0038877 Issued in IL

Legal business name

FOX RIVER PAVILION LIMITED PARTNERSHIP

Practice address

400 E New York St
Aurora, IL 60505-3425

Phone

(630) 897-8714

Fax

(630) 897-2312

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Scott T Braun

Title

Administrator

Phone

(630) 897-8714

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1821212739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E NEW YORK ST",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605053425",
            "telephone_number": "630-897-8714",
            "fax_number": "630-897-2312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E NEW YORK ST",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605053425",
            "telephone_number": "630-897-8714",
            "fax_number": "630-897-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX RIVER PAVILION LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BRAUN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "630-897-8714",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0038877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary K Formea, PT
• Madison Forthaus
• Deanna Foster
• Maya Foster
• Foundations Counseling and Assessments LLC
• Fox River Therapy LTD
• Fox Valley Cardiovascular Consultants, LLC
• Fox Valley Dermatology, LTD.
• Fox Valley Dialysis LTD
• Fox Valley Internist Inc.

• Skilled Nursing Facility in Aurora, IL
• Providers in Aurora, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.