Healthcare Provider Details

I. General information

NPI: 1205747367
Provider Name (Legal Business Name): MARY MARGARET FISCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 CHESTNUT AVE STE A
GLENVIEW IL
60026-8321
US

IV. Provider business mailing address

9200 N WASHINGTON ST
NILES IL
60714-1315
US

V. Phone/Fax

Practice location:
  • Phone: 847-657-3520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070041061
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: