Provider Demographics
NPI:1679911333
Name:D'SOUZA, SHERRY MARIA (MD)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:MARIA
Last Name:D'SOUZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:MARIA
Other - Last Name:ABRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1555 W PEARSON ST
Mailing Address - Street 2:APT B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-5227
Mailing Address - Country:US
Mailing Address - Phone:847-915-8473
Mailing Address - Fax:
Practice Address - Street 1:1776 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5453
Practice Address - Country:US
Practice Address - Phone:312-926-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036143576208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics