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General NPI Number Information
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NPI Number | 1346563921
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Entity Type | Organization
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Legal Business Name | SUSHIL K SHARMA MD SC
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Dates
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Enumeration Date | 03/10/2010
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Last Update Date | 03/10/2010
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Provider Practice Location Address
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Address Line | 9701 KNOX AVE STE 103
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City | SKOKIE
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State | IL
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Zip | 60076-1256
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Country | US
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Telephone | 847-933-6040
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Fax |
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Provider Business Mailing Address
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Address Line | 9600 GROSS POINT RD
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City | SKOKIE
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State | IL
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Zip | 60076-1214
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Country | US
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Telephone | 847-933-6040
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSHIL K SHARMA
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Credential | M.D. SC
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Telephone | 847-399-6167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036049977
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License Number State | IL
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