Individual provider Active NPI

Amy Fisher

  • Family Nurse Practitioner
  • Oak Lawn, IL
National Provider Identifier
1790464857
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.027843 Issued in IL
Practice address
4201 W 95TH St
Oak Lawn, IL 60453-2615
Phone
(708) 420-0182
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.027843 IL Primary

Addresses

Primary practice location

4201 W 95TH St
Oak Lawn, IL 60453-2615

Mailing address

9418 W 140TH St
Orland Park, IL 60462-2257
Phone (708) 420-0182

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
I20240814003001 IL Practitioner - Nurse Practitioner 8426596057 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.027843ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
P D Medical, S.C. CurrentSince Jul 29, 2024 Accepting new patients

Locations

3913 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-1444

4201 W 95th St
Oak Lawn, IL 60453
Phone (708) 636-1466

Organizations & group practices 1

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": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1790464857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9418 W 140TH ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622257",
            "telephone_number": "708-420-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532615",
            "telephone_number": "708-420-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.027843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.