MEDICARE: MRS. PRIYANKA SHARMA HAN APN

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	363LF0000X	Family Nurse Practitioner	209.028403	IL

General Provider Information

NPI Number	:	1548041676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PRIYANKA SHARMA HAN APN

Provider Business Mailing Address
First Line	:	308 HEMLOCK LN
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-5976
Country	:	US
Telephone Number	:	479-966-5261
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N RANDALL RD
Second Line	:
City	:	LAKE IN THE HILLS
State	:	IL
Zip	:	60156-5961
Country	:	US
Telephone Number	:	847-658-6065
Fax Number	:

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

Provider Enumeration Date	:	10/13/2023
Last Update Date	:	10/13/2023

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