MEDICARE: DR. APRIL M FETZER D.O.

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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	036111564	IL
2	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	OS16123	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	207067	OTHER	IL	MEDICARE PTAN LOCALITY 16
5	207073	OTHER	IL	MEDICARE PTAN LOCALITY 15
6	DA4902	OTHER		RAILROAD MEDICARE PTAN
7	P00180883	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1633878	OTHER	IL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	7205467	OTHER		AETNA

General Provider Information

NPI Number	:	1487633392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. APRIL M FETZER D.O.

Provider Business Mailing Address
First Line	:	1 WESTBROOK CORPORATE CTR
Second Line	:	#240
City	:	WESTCHESTER
State	:	IL
Zip	:	60154-5701
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7331 COLLEGE PKWY STE 300
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-5524
Country	:	US
Telephone Number	:	239-337-2003
Fax Number	:	239-337-3168

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	10/09/2019

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Directions to “ DR. APRIL M FETZER D.O.” Practice Location

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