Healthcare Provider Details

I. General information

NPI: 1356340822
Provider Name (Legal Business Name): SUMAN SHARMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 11/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3385 N ARLINGTON HEIGHTS RD SUITE A
ARLINGTON HEIGHTS IL
60004-7702
US

IV. Provider business mailing address

3385 N ARLINGTON HEIGHTS RD SUITE A
ARLINGTON HEIGHTS IL
60004-7702
US

V. Phone/Fax

Practice location:
  • Phone: 847-632-0600
  • Fax: 847-632-0604
Mailing address:
  • Phone: 847-632-0600
  • Fax: 847-632-0604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036075956
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: