Healthcare Provider Details

I. General information

NPI: 1316916885
Provider Name (Legal Business Name): ANN BRIGID FISCHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 ROOSEVELT RD
OAK PARK IL
60304-2303
US

IV. Provider business mailing address

166 N RIDGELAND AVE
OAK PARK IL
60302-2621
US

V. Phone/Fax

Practice location:
  • Phone: 708-848-8240
  • Fax: 708-383-2135
Mailing address:
  • Phone: 708-386-0526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036079693
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: