Individual
MRS. REBEKAH AUTUMN FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
115 E 1ST ST, SUITE 2W, HINSDALE, IL 60521-4280
(630) 734-0580
(630) 734-0581
Mailing address
1936 LEXINGTON AVE APT A, GREAT LAKES, IL 60088-1048
(847) 689-2196
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1067215
NCCPA CERT (NATIONAL)
—
Enumeration date
01/30/2006
Last updated
07/08/2007
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