Healthcare Provider Details

I. General information

NPI: 1447991401
Provider Name (Legal Business Name): DILLON SHARP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 W WACKER DR STE 120 PMB 2075
CHICAGO IL
60606
US

IV. Provider business mailing address

211 W WACKER DRIVE STE 120 PMB 2075
CHICAGO IL
60606
US

V. Phone/Fax

Practice location:
  • Phone: 312-535-4475
  • Fax:
Mailing address:
  • Phone: 312-535-4475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036174640
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: