Provider Demographics
NPI:1477098721
Name:YOUNGREN, SHARON
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:YOUNGREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:LEE
Other - Last Name:YOUNGREN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:888 S EDGELAWN DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-5283
Mailing Address - Country:US
Mailing Address - Phone:630-892-3240
Mailing Address - Fax:
Practice Address - Street 1:1190 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:ELBURN
Practice Address - State:IL
Practice Address - Zip Code:60119-7833
Practice Address - Country:US
Practice Address - Phone:630-643-1959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043.057344247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other