Provider Demographics
NPI:1477710788
Name:SHARMA, MONICA (DO)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N LAKE SHORE DR
Mailing Address - Street 2:SUITE 1231
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5640
Mailing Address - Country:US
Mailing Address - Phone:773-665-3261
Mailing Address - Fax:773-665-9435
Practice Address - Street 1:2900 N LAKE SHORE DR
Practice Address - Street 2:SUITE 1231
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5640
Practice Address - Country:US
Practice Address - Phone:773-665-3261
Practice Address - Fax:773-665-9435
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11013735A207RI0200X
IL036-116541207R00000X, 207RI0200X
IL036116541207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036116541Medicaid
IL1566005Medicare PIN
IL1566005, 1573005Medicare PIN
IL036116541Medicaid
IL1573005Medicare PIN