Provider Demographics
NPI:1821198714
Name:DR. SUDARSHAN K. SHARMA, LTD.
Entity Type:Organization
Organization Name:DR. SUDARSHAN K. SHARMA, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDARSHAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-856-6757
Mailing Address - Street 1:121 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3765
Mailing Address - Country:US
Mailing Address - Phone:630-856-6757
Mailing Address - Fax:630-887-1668
Practice Address - Street 1:121 N ELM ST
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3765
Practice Address - Country:US
Practice Address - Phone:630-856-6757
Practice Address - Fax:630-887-1668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D14867Medicare UPIN
IL214014Medicare PIN