MEDICARE: DR. MARYYAM SHARIF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	125.087216	IL

General Provider Information

NPI Number	:	1437084043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARYYAM SHARIF MD

Provider Business Mailing Address
First Line	:	1044 N MOZART ST STE 101
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2789
Country	:	US
Telephone Number	:	773-292-8300
Fax Number	:	773-292-2601

Provider Business Practice Location Address
First Line	:	1044 N MOZART ST STE 101
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2789
Country	:	US
Telephone Number	:	773-292-8300
Fax Number	:	773-292-2601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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