Active NPI
Deborah Fishman
- Ophthalmology Physician
- Wilmette, IL
National Provider Identifier
1982659314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 036084319
- Practice address
- 3612 Lake Ave
2C
Wilmette, IL 60091-1000 - Phone
- (847) 256-2020
- NPI assigned
- May 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 036084319 | IL | Primary |
Addresses
Primary practice location
3612 Lake Ave
2C
Wilmette, IL 60091-1000
Mailing address
3612 Lake Ave
2C
Wilmette, IL 60091-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036084319 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567036800000",
"number": "1982659314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3612 LAKE AVE",
"address_2": "2C",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600911000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3612 LAKE AVE",
"address_2": "2C",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600911000",
"telephone_number": "847-256-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHMAN",
"first_name": "DEBORAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-24",
"last_updated": "2019-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IL",
"license": "036084319",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036084319",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmette, IL
- Joan Myra Ferdinand, L.C.P.C.
- Annie Fernandez, PSYD
- Virginia Carol Fiedler, MD
- Sanford Irwin Finkel, M.D.
- Elysa B Fisher
- Fitlife Training LLC (Reavy Fitness)
- Allen Flower, RPH
- Forefront Dermatology, S.C. (The DERM, A Forefront Dermatology Practice)
- Lisa Jablon Fowler, L.C.P.C.
- Charles Samuel Fox, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.