Healthcare Provider Details

I. General information

NPI: 1508060716
Provider Name (Legal Business Name): SHARLA JANEEN PARKER MT(ASCP)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5TH & ROOSEVELT
HINES IL
60141
US

IV. Provider business mailing address

17450 BROOK HILL DR
ORLAND PARK IL
60467-7581
US

V. Phone/Fax

Practice location:
  • Phone: 708-202-5615
  • Fax:
Mailing address:
  • Phone: 708-479-5038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: