Provider Demographics
NPI:1659385128
Name:JAMES, SHARON MICHELE (MD)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:MICHELE
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:MICHELE
Other - Last Name:STIRGUS-JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 4685
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60680-4685
Mailing Address - Country:US
Mailing Address - Phone:708-333-3030
Mailing Address - Fax:708-333-6060
Practice Address - Street 1:15620 SOUTH WOOD STREET
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426-4171
Practice Address - Country:US
Practice Address - Phone:708-333-3030
Practice Address - Fax:708-333-6060
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100768207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036100768Medicaid
IL364385192OtherTAX ID
IL01630253OtherBLUE CROSS BLUE SHIELD
IL212568OtherGROUP PIN NUMBER
ILH25892Medicare UPIN
IL364385192OtherTAX ID