Provider Demographics
NPI:1689207946
Name:FISCUS, CASSI N (FNP-C)
Entity Type:Individual
Prefix:
First Name:CASSI
Middle Name:N
Last Name:FISCUS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CASSI
Other - Middle Name:N
Other - Last Name:KUBIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 N ALLEN ST
Mailing Address - Street 2:CASSI FISCUS
Mailing Address - City:ROBINSON
Mailing Address - State:IL
Mailing Address - Zip Code:62454
Mailing Address - Country:US
Mailing Address - Phone:618-546-2591
Mailing Address - Fax:618-546-2668
Practice Address - Street 1:1000 N ALLEN ST
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:IL
Practice Address - Zip Code:62454-1114
Practice Address - Country:US
Practice Address - Phone:618-546-2891
Practice Address - Fax:618-546-2668
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL30901022363L00000X
IL209025569363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner