Healthcare Provider Details

I. General information

NPI: 1275391401
Provider Name (Legal Business Name): SHARON FISCH-REICHLER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

778 W FRONTAGE RD STE 122
NORTHFIELD IL
60093-1209
US

IV. Provider business mailing address

1758 WINTHROP RD
HIGHLAND PARK IL
60035-3732
US

V. Phone/Fax

Practice location:
  • Phone: 847-334-1833
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SHARON FISCH-REICHLER
Title or Position: OWNER
Credential: LCSW
Phone: 847-334-1833