Individual provider Active NPI

Deborah Feingold-Fisher, LCSW, RN, APRN

  • Nurse Practitioner
  • Evanston, IL
National Provider Identifier
1235752742
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209026291 Issued in IL
Practice address
1000 Central St
Evanston, IL 60201-1777
Phone
(847) 570-1000
NPI assigned
May 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209026291 IL Primary
Clinical Social Worker 1041C0700X 14900579 IL
Pediatric Nurse Practitioner 363LP0200X 209026291 IL

Addresses

Primary practice location

1000 Central St
Evanston, IL 60201-1777

Mailing address

4001 Grant St
Skokie, IL 60076-1109
Phone (847) 987-7110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230901001472 IL Practitioner - Nurse Practitioner 8729441126 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
14900579ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Aug 15, 2023 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

1000 Central St
Evanston, IL 60201
Phone (847) 570-1000

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1235752742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 GRANT ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761109",
            "telephone_number": "847-987-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CENTRAL ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011777",
            "telephone_number": "847-570-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEINGOLD-FISHER",
        "first_name": "DEBORAH",
        "credential": "LCSW, RN, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209026291",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "14900579",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209026291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.