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 1:1100 JORIE BLVD STE 272
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4426
Mailing Address - Country:US
Mailing Address - Phone:630-571-4503
Mailing Address - Fax:630-756-4176
Practice Address - Street 1:1100 JORIE BLVD STE 272
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4426
Practice Address - Country:US
Practice Address - Phone:630-571-4503
Practice Address - Fax:630-756-4176
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-004119103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL071-004119OtherSTATE LICENSE NUMBER