MEDICARE: DR. JAMES S FISTER M.D.

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
1	207XS0117X	Orthopaedic Surgery of the Spine Physician	036059573	IL
2	207X00000X	Orthopaedic Surgery Physician	036059573	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	208821	OTHER	MEDICARE GRP KANE
2	200015630	OTHER	RR MEDICARE
3	CE6001	OTHER	RR MEDICARE GRP-KANE CTY
5	207906	OTHER	MEDICARE GRP-MCH
6	CG2631	OTHER	RR MEDICARE GRP-MCHENRY C

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174631188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES S FISTER M.D.

Provider Business Mailing Address
First Line	:	36W431 HUNTERS GATE RD
Second Line	:
City	:	SAINT CHARLES
State	:	IL
Zip	:	60175-5129
Country	:	US
Telephone Number	:	630-584-7397
Fax Number	:

Provider Business Practice Location Address
First Line	:	36W431 HUNTERS GATE RD
Second Line	:
City	:	SAINT CHARLES
State	:	IL
Zip	:	60175-5129
Country	:	US
Telephone Number	:	630-584-7397
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	08/22/2025

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Directions to “ DR. JAMES S FISTER M.D.” Practice Location

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