Healthcare Provider Details

I. General information

NPI: 1316692874
Provider Name (Legal Business Name): SHAREKA D HORTON RHIT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2022
Last Update Date: 02/14/2022
Certification Date: 02/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 S SPRINGFIELD AVE APT 1
CHICAGO IL
60624-4483
US

IV. Provider business mailing address

823 S SPRINGFIELD AVE APT 1
CHICAGO IL
60624-4483
US

V. Phone/Fax

Practice location:
  • Phone: 224-325-5839
  • Fax: 224-241-3836
Mailing address:
  • Phone: 224-325-5839
  • Fax: 224-241-3836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number246144
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: