MEDICARE: DIVYA J SHARMA DC

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	111N00000X	Chiropractor	038-009825	IL

General Provider Information

NPI Number	:	1356410492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIVYA J SHARMA DC

Provider Business Mailing Address
First Line	:	195 N HARBOR DR
Second Line	:	UNIT # 2908
City	:	CHICAGO
State	:	IL
Zip	:	60601-7514
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2202 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-7170
Country	:	US
Telephone Number	:	773-469-7622
Fax Number	:	312-552-0010

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	04/20/2009

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Directions to “ DIVYA J SHARMA DC” Practice Location

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