Individual provider Active NPI

De'Eric Fisher

  • Massage Therapist
  • Chicago, IL
National Provider Identifier
1689568313
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227.024241 Issued in IL
Practice address
1163 N State St Lowr Level
Chicago, IL 60610-2722
Phone
(773) 780-4653
NPI assigned
Jun 6, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227.024241 IL Primary

Addresses

Primary practice location

1163 N State St Lowr Level
Chicago, IL 60610-2722

Mailing address

1030 N Dearborn St Apt 1218
Chicago, IL 60610-5045
Phone (773) 780-4653

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

State licenses

LicenseStateTypeSpecialty
227.024241ILMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1689568313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 N DEARBORN ST APT 1218",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606105045",
            "telephone_number": "773-780-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 N STATE ST LOWR LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102722",
            "telephone_number": "773-780-4653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "DE'ERIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.024241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; 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.