Provider Demographics
NPI:1730247859
Name:FISCHER, TESSA R (MD)
Entity type:Individual
Prefix:DR
First Name:TESSA
Middle Name:R
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:800 AUSTIN WEST TOWER
Mailing Address - Street 2:SUITE 409
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202
Mailing Address - Country:US
Mailing Address - Phone:847-733-1495
Mailing Address - Fax:847-733-1994
Practice Address - Street 1:800 AUSTIN WEST TOWER
Practice Address - Street 2:SUITE 409
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202
Practice Address - Country:US
Practice Address - Phone:847-733-1495
Practice Address - Fax:847-733-1994
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2012-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036053924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036053924Medicaid
D14136Medicare UPIN