Healthcare Provider Details

I. General information

NPI: 1679500292
Provider Name (Legal Business Name): JULIE ANN FLEISCHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE A SCHIEN

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 10/21/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N 8TH ST SUITE 4A
SPRINGFIELD IL
62701-1041
US

IV. Provider business mailing address

301 N 8TH ST PO BOX 19658
SPRINGFIELD IL
62701-1041
US

V. Phone/Fax

Practice location:
  • Phone: 217-545-8000
  • Fax: 217-545-5018
Mailing address:
  • Phone: 217-545-8000
  • Fax: 217-545-5018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number036-103697
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036-103697
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: