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NPI Code Detail

MEDICARE: STEVEN A FISCHMAN D.D.S.

MEDICARE: STEVEN A FISCHMAN D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryIL

General Provider Information

NPI Number : 1083698054
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN A FISCHMAN D.D.S.
Provider Business Mailing Address
First Line : 77 LARKDALE EAST RD
Second Line :
City : DEERFIELD
State : IL
Zip : 60015-5055
Country : US
Telephone Number : 847-436-5077
Fax Number : 847-940-9885
Provider Business Practice Location Address
First Line : 5137 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60651-2904
Country : US
Telephone Number : 847-436-5077
Fax Number : 847-940-9885
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 07/08/2007

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