Healthcare Provider Details

I. General information

NPI: 1588544985
Provider Name (Legal Business Name): NATEA FISHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W GRAND AVE STE 500
CHICAGO IL
60654-6799
US

IV. Provider business mailing address

502 MAIN ST
MARSEILLES IL
61341-1419
US

V. Phone/Fax

Practice location:
  • Phone: 800-325-1812
  • Fax:
Mailing address:
  • Phone: 815-513-3654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: