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General NPI Number Information
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NPI Number | 1700967684
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Entity Type | Individual
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Provider Name | DAVID LEON FISHMAN MD
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 09/28/2007
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Provider Practice Location Address
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Address Line | 5600 W ADDISON ST SUITE 505
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City | CHICAGO
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State | IL
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Zip | 60634-4401
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Country | US
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Telephone | 773-282-3311
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Fax | 773-794-7365
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Provider Business Mailing Address
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Address Line | 5600 W ADDISON ST SUITE 505
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City | CHICAGO
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State | IL
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Zip | 60634-4401
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Country | US
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Telephone | 773-282-3311
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Fax | 773-794-7365
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State | IL
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