Provider Demographics
NPI:1780832147
Name:SHARMA, NEELIMA (MD)
Entity Type:Individual
Prefix:
First Name:NEELIMA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 W FULLERTON AVE
Mailing Address - Street 2:ADDISON MEDICAL ASSOCIATES
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-3767
Mailing Address - Country:US
Mailing Address - Phone:630-543-5454
Mailing Address - Fax:630-543-5471
Practice Address - Street 1:276 W FULLERTON AVE
Practice Address - Street 2:ADDISON MEDICAL ASSOCIATES
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-3767
Practice Address - Country:US
Practice Address - Phone:630-543-5454
Practice Address - Fax:630-543-5471
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036122779207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036122779Medicaid