Healthcare Provider Details

I. General information

NPI: 1629509237
Provider Name (Legal Business Name): DUAA SHARFI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 S KEDZIE AVE STE C
MERRIONETTE PARK IL
60803-6307
US

IV. Provider business mailing address

2640 183RD ST
HOMEWOOD IL
60430-2914
US

V. Phone/Fax

Practice location:
  • Phone: 708-388-4400
  • Fax: 708-389-8484
Mailing address:
  • Phone: 708-798-6633
  • Fax: 708-798-6790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number295396
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036171371
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number88098
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number036171371
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: