Provider Demographics
NPI:1508072448
Name:FICHTER, ROBERT STEVEN (ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:STEVEN
Last Name:FICHTER
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 CHARLEVOIX WAY
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-1292
Mailing Address - Country:US
Mailing Address - Phone:708-220-7670
Mailing Address - Fax:
Practice Address - Street 1:999 KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2248
Practice Address - Country:US
Practice Address - Phone:708-335-5120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096-016052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer