Healthcare Provider Details

I. General information

NPI: 1760932255
Provider Name (Legal Business Name): MS. ERIN C. SHARP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 OAK ST
WINNETKA IL
60093-2522
US

IV. Provider business mailing address

690 OAK ST
WINNETKA IL
60093-2522
US

V. Phone/Fax

Practice location:
  • Phone: 847-446-6955
  • Fax: 847-446-6957
Mailing address:
  • Phone: 847-446-6955
  • Fax: 847-446-6957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number208.000381
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: