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General NPI Number Information
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NPI Number | 1194971416
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Entity Type | Individual
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Provider Name | CHETAN SHARMA MD
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Gender | Male
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 2000 OGDEN AVE. SUITE 330
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City | AURORA
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State | IL
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Zip | 60504-5897
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Country | US
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Telephone | 630-978-4850
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Fax |
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Provider Business Mailing Address
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Address Line | 2515 VERSAILLES AVE APT 106
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City | NAPERVILLE
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State | IL
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Zip | 60540-1990
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Country | US
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Telephone | 630-802-7478
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 125.055010
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License Number State | IL
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