Provider Demographics
NPI:1346051455
Name:FOX, GRACE KATHERINE
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:KATHERINE
Last Name:FOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 N 6TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-3484
Mailing Address - Country:US
Mailing Address - Phone:877-243-0001
Mailing Address - Fax:
Practice Address - Street 1:304 N 6TH ST STE C
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-3484
Practice Address - Country:US
Practice Address - Phone:877-243-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker