Provider Demographics
NPI:1033293493
Name:SHARMA, RANI (MD)
Entity Type:Individual
Prefix:DR
First Name:RANI
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E PARK AVE
Mailing Address - Street 2:SUITE # 103
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-2800
Mailing Address - Country:US
Mailing Address - Phone:847-968-2800
Mailing Address - Fax:847-968-2801
Practice Address - Street 1:131 E PARK AVE
Practice Address - Street 2:SUITE # 103
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-2800
Practice Address - Country:US
Practice Address - Phone:847-968-2800
Practice Address - Fax:847-968-2801
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036103630207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH36585Medicare UPIN