Individual
DR. THOMAS LEE FISHER SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
47 W POLK ST LBBY G1, CHICAGO, IL 60605-2087
(312) 922-3011
(312) 922-5875
Mailing address
47 W POLK ST LBBY G1, CHICAGO, IL 60605-2087
(312) 922-3011
(312) 922-5875
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036-043966
IL
207ND0900X
Dermatopathology Physician
036-043966
IL
207NS0135X
Procedural Dermatology Physician
036-043966
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036--043966
—
IL
Enumeration date
07/12/2006
Last updated
08/09/2022
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