Provider Demographics
NPI:1811099294
Name:FISHER, CLAUDIA ANN (PT)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ANN
Last Name:FISHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1161 KASTING LN
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-9147
Mailing Address - Country:US
Mailing Address - Phone:847-566-7866
Mailing Address - Fax:
Practice Address - Street 1:600 WAUKEGAN RD
Practice Address - Street 2:UNIT 132
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1258
Practice Address - Country:US
Practice Address - Phone:847-784-8733
Practice Address - Fax:847-739-7164
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070006291225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist