Provider Demographics
NPI:1336459502
Name:HOLLOWAY, SHARON M (NP)
Entity Type:Individual
Prefix:MISS
First Name:SHARON
Middle Name:M
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:180 HARVESTER DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7594
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5841 S MARYLAND AVE
Practice Address - Street 2:MC 9024, M555
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1447
Practice Address - Country:US
Practice Address - Phone:773-702-5988
Practice Address - Fax:773-702-4666
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209002244363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care