Provider Demographics
NPI:1487982229
Name:FOX VALLEY HEMATOLOGY INC
Entity type:Organization
Organization Name:FOX VALLEY HEMATOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-931-0909
Mailing Address - Street 1:1710 N RANDALL RD
Mailing Address - Street 2:STE 300
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-9400
Mailing Address - Country:US
Mailing Address - Phone:847-931-0909
Mailing Address - Fax:847-931-0939
Practice Address - Street 1:10350 HALIGUS RD
Practice Address - Street 2:STE 210
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9545
Practice Address - Country:US
Practice Address - Phone:847-802-7880
Practice Address - Fax:847-931-0939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty