Healthcare Provider Details

I. General information

NPI: 1104447663
Provider Name (Legal Business Name): VIRGINIA KATE SCHARF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2020
Last Update Date: 06/27/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 W HARRISON ST
CHICAGO IL
60607-3106
US

IV. Provider business mailing address

1520 W HARRISON ST
CHICAGO IL
60607-3106
US

V. Phone/Fax

Practice location:
  • Phone: 312-563-2531
  • Fax:
Mailing address:
  • Phone: 312-563-2531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number125.081296
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: