Healthcare Provider Details

I. General information

NPI: 1679721351
Provider Name (Legal Business Name): SAMEER SHARMA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5815 S CALUMET AVE
HAMMOND IN
46320-2352
US

IV. Provider business mailing address

195 N HARBOR DR #2908
CHICAGO IL
60601-7532
US

V. Phone/Fax

Practice location:
  • Phone: 312-523-6837
  • Fax: 312-552-0010
Mailing address:
  • Phone: 312-523-6837
  • Fax: 312-552-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMEER SHARMA
Title or Position: PRESIDENT
Credential: MD
Phone: 312-523-6837