# FOX VALLEY OPHTHALMOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528238854
- **Authorized official:** MS. SUSAN C MOSS (ADMINISTRATOR)
- **Authorized official phone:** (630) 584-9850

## Contact information

- **Practice address:** 40W330 LAFOX RD, ST CHARLES, IL 60175-6515
- **Practice address phone:** (630) 584-9850
- **Practice address fax:** (630) 584-1523
- **Mailing address:** 750 FLETCHER DR STE 106, ELGIN, IL 60123-4703
- **Mailing address phone:** (847) 695-0499
- **Mailing address fax:** (847) 695-4339

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 042002501 | IL | Yes |

## Other

- **Enumeration date:** 03/03/2008
- **Last updated:** 04/23/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 04519570 | BCBS | IL |
| 01 | — | 379827 | UNITED HEALTHCARE | IL |
| 01 | — | CL1986 | MEDICARE RAILROAD | IL |