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General NPI Number Information
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NPI Number | 1386962736
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Entity Type | Individual
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Provider Name | ASTHA KHANNA SHARMA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 05/03/2021
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Provider Practice Location Address
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Address Line | 225 E CHICAGO AVE
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City | CHICAGO
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State | IL
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Zip | 60611-2991
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Country | US
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Telephone | 312-227-1614
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Fax |
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Provider Business Mailing Address
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Address Line | 1160 S MICHIGAN AVE UNIT #3302
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City | CHICAGO
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State | IL
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Zip | 60605-2776
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Country | US
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Telephone | 973-641-1231
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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 | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 036132870
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License Number State | IL
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