Individual provider Active NPI

Adam Robert Fisher, PH.D.

  • Psychologist
  • Evanston, IL
National Provider Identifier
1679752901
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071.009523 Issued in IL
Practice address
618 Library PL
Evanston, IL 60201-2908
Phone
(847) 733-4300
NPI assigned
Nov 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.009523 IL Primary

Addresses

Primary practice location

618 Library PL
Evanston, IL 60201-2908

Mailing address

1326 Chicago Ave Apt 202
Evanston, IL 60201-4786
Phone (812) 325-8597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.009523ILMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1194048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1679752901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 CHICAGO AVE APT 202",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014786",
            "telephone_number": "812-325-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 LIBRARY PL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012908",
            "telephone_number": "847-733-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "ADAM",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-03",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.009523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.