MEDICARE: MARGARET SHARICE WARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1225670151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET SHARICE WARD

Provider Business Mailing Address
First Line	:	1995 W MEADOWVIEW DR
Second Line	:
City	:	ROUND LAKE
State	:	IL
Zip	:	60073-9793
Country	:	US
Telephone Number	:	224-388-1202
Fax Number	:

Provider Business Practice Location Address
First Line	:	1995 W MEADOWVIEW DR
Second Line	:
City	:	ROUND LAKE
State	:	IL
Zip	:	60073-9793
Country	:	US
Telephone Number	:	224-388-1202
Fax Number	:	847-201-2661

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2019
Last Update Date	:	10/11/2019

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