MEDICARE: MICHELLE FISHER LCSW

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	1041C0700X	Clinical Social Worker	149.009765	IL

General Provider Information

NPI Number	:	1326495243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE FISHER LCSW

Provider Business Mailing Address
First Line	:	4711 GOLF RD
Second Line	:	SUITE 400
City	:	SKOKIE
State	:	IL
Zip	:	60076-1224
Country	:	US
Telephone Number	:	847-284-3134
Fax Number	:

Provider Business Practice Location Address
First Line	:	4711 GOLF RD
Second Line	:	SUITE 400
City	:	SKOKIE
State	:	IL
Zip	:	60076-1224
Country	:	US
Telephone Number	:	847-284-3134
Fax Number	:

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

Provider Enumeration Date	:	05/20/2016
Last Update Date	:	04/12/2026

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