Provider Demographics
NPI:1629743570
Name:FISHER, EMILEE MARIAN (BS, MA)
Entity Type:Individual
Prefix:MISS
First Name:EMILEE
Middle Name:MARIAN
Last Name:FISHER
Suffix:
Gender:F
Credentials:BS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-9542
Mailing Address - Country:US
Mailing Address - Phone:630-383-1621
Mailing Address - Fax:
Practice Address - Street 1:960 E CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5510
Practice Address - Country:US
Practice Address - Phone:630-579-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF260-2139-6767Medicaid