Fisher, Shontae L
Fisher, Shontae L is an sole proprietor health care provider with primary practice located at 313 Berkshire Dr , Lake Villa IL 60046-5054. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Fisher, Shontae L can be contacted via phone (773) 220-6268.Contact Information
Primary practice address
313 Berkshire Dr
Lake Villa IL 60046-5054
Phone: (773) 220-6268
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 00000000000 | Illinois |
Profile Details
| NPI number | 1609621796 |
|---|---|
| LBN Legal business name | Fisher, Shontae L |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 22nd, 2024 |
| Last updated | Apr 22nd, 2024 - about 7 months 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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