Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 038005721 | IL |
NPI | 1295977791 |
---|---|
Provider Name | Dr. Camille Fox |
First Address | Downers Grove, IL 60515-1625 |
Second Address | Downers Grove, IL 60515-1625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2009 |
Last Update Date | 30/03/2009 |