Provider Demographics
NPI:1952318438
Name:FISHER, DANIEL PETER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PETER
Last Name:FISHER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 S. YORK RD.
Mailing Address - Street 2:#215
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126
Mailing Address - Country:US
Mailing Address - Phone:630-941-1551
Mailing Address - Fax:630-941-7944
Practice Address - Street 1:116 S. YORK RD.
Practice Address - Street 2:#215
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126
Practice Address - Country:US
Practice Address - Phone:630-941-1551
Practice Address - Fax:630-941-7944
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical