Healthcare Provider Details

I. General information

NPI: 1831570720
Provider Name (Legal Business Name): GAURAV KUMAR SHARMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2088 OGDEN AVE STE 160
AURORA IL
60504-4383
US

IV. Provider business mailing address

2088 OGDEN AVE STE 160
AURORA IL
60504-4383
US

V. Phone/Fax

Practice location:
  • Phone: 630-851-6440
  • Fax:
Mailing address:
  • Phone: 630-851-6440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036144047
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036144047
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number036144047
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: