Healthcare Provider Details

I. General information

NPI: 1346442654
Provider Name (Legal Business Name): SHARON M BUX LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHARON M STRICKLAND LCSW

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 DEMPSTER ST
PARK RIDGE IL
60068-8412
US

IV. Provider business mailing address

2604 DEMPSTER ST
PARK RIDGE IL
60068-8412
US

V. Phone/Fax

Practice location:
  • Phone: 847-544-5102
  • Fax: 847-544-5103
Mailing address:
  • Phone: 847-544-5102
  • Fax: 847-544-5103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149011547
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: