Provider Demographics
NPI:1609079086
Name:SIKORA, SHARON M (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:M
Last Name:SIKORA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N WABASH AVENUE
Mailing Address - Street 2:SUITE 1121
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602
Mailing Address - Country:US
Mailing Address - Phone:312-782-5662
Mailing Address - Fax:312-782-5663
Practice Address - Street 1:111 N WABASH AVENUE
Practice Address - Street 2:SUITE 1121
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602
Practice Address - Country:US
Practice Address - Phone:312-782-5662
Practice Address - Fax:312-782-5663
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019016916122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL12369OtherBC/BS OF IL PROVIDER NUMBER