Provider Demographics
NPI:1235126236
Name:FISHER, DONALD H (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:H
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1800 HOLLISTER DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5263
Mailing Address - Country:US
Mailing Address - Phone:847-362-2500
Mailing Address - Fax:847-362-5151
Practice Address - Street 1:1800 HOLLISTER DR
Practice Address - Street 2:SUITE 107
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5233
Practice Address - Country:US
Practice Address - Phone:847-362-2500
Practice Address - Fax:847-362-5151
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2015-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-063243208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD15615Medicare UPIN