NPI 1063556066

Wm. W. Fox Developmental Center 3b

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Dwight, IL

Practice location

Address: 134 W Main St, Dwight, IL 60420-1322
Phone: (815) 584-3347

Authorised official

Name: Gus Pedraza
Title: Medical Director
Phone: (815) 584-3347

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Illinois →

Registry record

NPI: 1063556066
Entity type: Organization
NPI issued: 16 Feb 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.