Provider Demographics
NPI:1033462718
Name:FISCUS, MICHELE (HAD)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:FISCUS
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:CURRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:597 N YORK ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1903
Mailing Address - Country:US
Mailing Address - Phone:630-833-8382
Mailing Address - Fax:630-833-8158
Practice Address - Street 1:790 HAMPSHIRE RD STE B
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-5936
Practice Address - Country:US
Practice Address - Phone:805-496-3553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3063237700000X
CA8225237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist