Healthcare Provider Details

I. General information

NPI: 1699926303
Provider Name (Legal Business Name): OSCAR E FISCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W TAYLOR ST SUITE NUMBER 3200 WEST
CHICAGO IL
60612-7232
US

IV. Provider business mailing address

817 WEST LAFLIN ST NUMBER 1 FRONT
CHICAGO IL
60661
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-4020
  • Fax:
Mailing address:
  • Phone: 773-315-8472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number125050048
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: