Healthcare Provider Details
I. General information
NPI: 1821198714
Provider Name (Legal Business Name): DR. SUDARSHAN K. SHARMA, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2006
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
121 N ELM ST
HINSDALE IL
60521-3765
US
IV. Provider business mailing address
121 N ELM ST
HINSDALE IL
60521-3765
US
V. Phone/Fax
- Phone: 630-856-6757
- Fax: 630-887-1668
- Phone: 630-856-6757
- Fax: 630-887-1668
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SUDARSHAN
K.
SHARMA
Title or Position: OWNER
Credential: M.D.
Phone: 630-856-6757