Provider Demographics
NPI:1235752742
Name:FEINGOLD-FISHER, DEBORAH (LCSW, RN, APRN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:FEINGOLD-FISHER
Suffix:
Gender:F
Credentials:LCSW, RN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1109
Mailing Address - Country:US
Mailing Address - Phone:847-987-7110
Mailing Address - Fax:
Practice Address - Street 1:1000 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1777
Practice Address - Country:US
Practice Address - Phone:847-570-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209026291363L00000X, 363LP0200X
IL149005791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics