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NPI 1760294649

NPI 1760294649 : FITTER HEALTHCARE, LLC : ST CHARLES, IL

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General NPI Number Information
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    NPI Number           |    1760294649
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    Entity Type          |    Organization 
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    Legal Business Name  |    FITTER HEALTHCARE, LLC 
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Dates
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    Enumeration Date     |    01/27/2025
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    Last Update Date     |    01/27/2025
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Provider Practice Location Address
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    Address Line         |    455 DUNHAM RD STE 100 
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    City                 |    ST CHARLES
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    State                |    IL
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    Zip                  |    60174-1453
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    Country              |    US
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    Telephone            |    630-765-0026
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1114 LONDONBERRY LN 
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    City                 |    GLEN ELLYN
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    State                |    IL
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    Zip                  |    60137-6110
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MANAGING MEMBER
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    Name                 |     FAWAD  FITTER 
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    Credential           |    MD
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    Telephone            |    630-765-0026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0801X
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    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    261QM0855X
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    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    261QP2300X
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    Taxonomy Name        |    Primary Care Clinic/Center
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    License Number       |    
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    License Number State |    
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