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Organization
WM. W. FOX DEVELOPMENTAL CENTER 1C
Active
Organization
WM. W. FOX DEVELOPMENTAL CENTER 1C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUS PEDRAZA (MEDICAL DIRECTOR)
(815) 584-3347
Entity
Organization
Contact information
Practice address
134 W MAIN ST, DWIGHT, IL 60420-1322
(815) 584-3347
Mailing address
134 W MAIN ST, DWIGHT, IL 60420-1322
(815) 584-3347
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/16/2007
Last updated
08/22/2020
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