Provider Demographics
NPI:1184839656
Name:FISHMAN, MARYANNE (RN, MS, AOCN)
Entity type:Individual
Prefix:MS
First Name:MARYANNE
Middle Name:
Last Name:FISHMAN
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Gender:F
Credentials:RN, MS, AOCN
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Mailing Address - Street 1:676 N SAINT CLAIR ST
Mailing Address - Street 2:STEM CELL TRANSPLANT SUITE 1920
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2927
Mailing Address - Country:US
Mailing Address - Phone:312-695-6510
Mailing Address - Fax:312-926-2978
Practice Address - Street 1:676 N SAINT CLAIR ST
Practice Address - Street 2:STEM CELL TRANSPLANT SUITE 1920
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2927
Practice Address - Country:US
Practice Address - Phone:312-695-6510
Practice Address - Fax:312-926-2978
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2020-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209002552364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209-002552OtherADVANCED PRACTICE NURSE