Healthcare Provider Details
I. General information
NPI: 1326032996
Provider Name (Legal Business Name): SHERI S FISHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/09/2005
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2601 COMPASS RD SUITE 120
GLENVIEW IL
60026
US
IV. Provider business mailing address
1460 N HALSTED ST SUITE 402
CHICAGO IL
60642
US
V. Phone/Fax
- Phone: 847-998-8806
- Fax: 847-998-8807
- Phone: 312-279-8900
- Fax: 312-981-6312
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 036112039 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: