Fischer, Justin Lee

Fischer, Justin Lee is an sole proprietor health care provider with primary practice located at 1001 Main St Ste 300, Peoria IL 61606-2036. He recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as his primary health care specialty. Fischer, Justin Lee can be contacted via phone (309) 495-0201.

Contact Information

Primary practice address
1001 Main St Ste 300 Peoria IL 61606-2036
Phone: (309) 495-0201
Fax: (309) 676-6545
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 036139889 Illinois

Profile Details

NPI number 1730456914
LBN Legal business name Fischer, Justin Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 16th, 2011
Last updated Jul 1st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730456914 NPPES
Illinois MEDICAID 36139889-1

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