Provider Demographics
NPI:1316916885
Name:FISCHER, ANN BRIGID (MD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:BRIGID
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 N RIDGELAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2621
Mailing Address - Country:US
Mailing Address - Phone:708-386-0526
Mailing Address - Fax:
Practice Address - Street 1:6300 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-2303
Practice Address - Country:US
Practice Address - Phone:708-848-8240
Practice Address - Fax:708-383-2135
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036079693208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036079693Medicaid