Individual
DR. ILYA ISAAKOVICH FISHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.118688
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036.118688
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316169949
NPI, TYPE 2
IL
01
—
1407219504
ORGANIZATIONAL NPI
IL
Enumeration date
08/30/2007
Last updated
04/11/2016
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