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NPI Code Detail

MEDICARE: MADELINE R FISCHER

MEDICARE: MADELINE R FISCHER
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
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician Assistant085008668IL

General Provider Information

NPI Number : 1295408573
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE R FISCHER
Provider Business Mailing Address
First Line : 245 W ROOSEVELT RD STE 150
Second Line :
City : WEST CHICAGO
State : IL
Zip : 60185-4818
Country : US
Telephone Number : 630-293-4124
Fax Number :
Provider Business Practice Location Address
First Line : 245 W ROOSEVELT RD STE 150
Second Line :
City : WEST CHICAGO
State : IL
Zip : 60185-4818
Country : US
Telephone Number : 630-293-4124
Fax Number : 630-293-9909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2021
Last Update Date : 11/03/2023

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Directions to “ MADELINE R FISCHER ” Practice Location

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