Individual provider Active NPI

Daniel Peter Fisher, PSY.D.

  • Clinical Psychologist
  • Oak Brook, IL
National Provider Identifier
1952318438
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-004119 Issued in IL
Practice address
1100 Jorie Blvd Ste 272
Oak Brook, IL 60523-4426
Phone
(630) 571-4503
Fax
(630) 756-4176
NPI assigned
Aug 1, 2006
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-004119 IL Primary

Addresses

Primary practice location

1100 Jorie Blvd Ste 272
Oak Brook, IL 60523-4426

Mailing address

1100 Jorie Blvd Ste 272
Oak Brook, IL 60523-4426
Phone (630) 571-4503

Other identifiers 1

IdentifierTypeStateIssuer
071-004119OtherILSTATE LICENSE NUMBER

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111229000061 IL Practitioner - Clinical Psychologist 6709052525 Practice locations: Oak Brook, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1100 Jorie Blvd
Suite 272
Oak Brook, IL 60523-4426
Phone (630) 941-1551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-004119ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1952318438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JORIE BLVD STE 272",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605234426",
            "telephone_number": "630-571-4503",
            "fax_number": "630-756-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JORIE BLVD STE 272",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605234426",
            "telephone_number": "630-571-4503",
            "fax_number": "630-756-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "DANIEL",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-004119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "071-004119",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

Verify at the official NPI Registry.