Healthcare Provider Details

I. General information

NPI: 1376959981
Provider Name (Legal Business Name): AARTI SHARMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 S MARYLAND AVE RM P-615
CHICAGO IL
60637-1447
US

IV. Provider business mailing address

5841 S. MARYLAND AVENUE (MC 3083)
CHICAGO IL
60615
US

V. Phone/Fax

Practice location:
  • Phone: 773-834-8376
  • Fax:
Mailing address:
  • Phone: 773-834-7708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2014020112
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number125.069986
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: