Provider Demographics
NPI:1073509584
Name:LUDWIG, SHARI S (MD)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:S
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:777 OAKMONT LN
Mailing Address - Street 2:SUITE1600
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5511
Mailing Address - Country:US
Mailing Address - Phone:630-789-2550
Mailing Address - Fax:
Practice Address - Street 1:4440 W 95TH ST
Practice Address - Street 2:EMG LAB, ROOM 042 SOUTH
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:708-684-5428
Practice Address - Fax:708-684-2079
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036073770208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL250002471OtherRAILROAD MEDICARE
IL36354817306OtherADVOCATE HLTH CENTERS ID
IL131667300OtherWORKERS COMPENSATION
IL47610OtherADVOCATE HLTH PARTNERS ID
IL01621490OtherBCBS PROVIDER ID
IL036073770Medicaid