Individual provider Active NPI

Michael Alan Fisher, MD

  • Family Medicine Physician
  • Park Ridge, IL
National Provider Identifier
1760481220
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036090789 Issued in IL
Practice address
10 N Cumberland Ave
Park Ridge, IL 60068-3215
Phone
(847) 825-0300
NPI assigned
Jul 18, 2005
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036090789 IL Primary

Addresses

Primary practice location

10 N Cumberland Ave
Park Ridge, IL 60068-3215

Mailing address

29373 Network PL
Chicago, IL 60673-1293

Other practice location 1

7900 N Milwaukee Ave
234
Niles, IL 60714-3159
Phone (847) 966-1750

Other identifiers 2

IdentifierTypeStateIssuer
036090789MedicaidIL
1634494OtherILBLUE CROSS BLUE SHIELD

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https:EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address mfisher250904@direct.myadvocateaurora.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105000239 IL Practitioner - Family Practice 7315900016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rush Medical College of Rush University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10 N Cumberland Ave
Park Ridge, IL 60068-3215
Phone (847) 825-0300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jul 31, 2023 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 31, 2023 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

7900 N Milwaukee Ave
Ste 234
Niles, IL 60714
Phone (847) 663-1638

10 N Cumberland Ave
Park Ridge, IL 60068
Phone (847) 825-0300

1775 Ballard Rd
Park Ridge, IL 60068
Phone (847) 318-6020

Interoperability endpoints

  • Direct secure messaging: mfisher250904@direct.myadvocateaurora.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1760481220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N CUMBERLAND AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683215",
            "telephone_number": "847-825-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7900 N Milwaukee Ave",
            "address_2": "234",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "IL",
            "postal_code": "607143159",
            "country_code": "US",
            "telephone_number": "847-966-1750",
            "fax_number": "847-966-2724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISHER",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036090789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090789",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1634494",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "7900 N Milwaukee Ave",
            "address_2": "234",
            "city": "Niles",
            "state": "IL",
            "country_code": "US",
            "postal_code": "607143159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfisher250904@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10 N Cumberland Ave",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600683215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.