Provider Demographics
NPI:1326567173
Name:SHARMA, BHAVNA (APN-CNP)
Entity Type:Individual
Prefix:MS
First Name:BHAVNA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 W CENTRAL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2407
Mailing Address - Country:US
Mailing Address - Phone:847-618-2500
Mailing Address - Fax:847-253-8474
Practice Address - Street 1:1632 W CENTRAL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2407
Practice Address - Country:US
Practice Address - Phone:847-618-2500
Practice Address - Fax:847-253-8474
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-377098163W00000X
IL209-016150363LF0000X
IL209016150363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1720371669OtherGROUP NPI
IL209016150OtherSTATE LICENSE
ILIL6305OtherGROUP MEDICARE PTAN
ILIL6304OtherGROUP MEDICARE PTAN