Healthcare Provider Details

I. General information

NPI: 1689728024
Provider Name (Legal Business Name): SHARON J DURFEE D.D.S.,M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 CENTRAL ST
EVANSTON IL
60201-1101
US

IV. Provider business mailing address

3000 CENTRAL ST
EVANSTON IL
60201-1101
US

V. Phone/Fax

Practice location:
  • Phone: 847-866-7755
  • Fax: 847-866-7759
Mailing address:
  • Phone: 847-866-7755
  • Fax: 847-866-7759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: