Provider Demographics
NPI:1952308355
Name:BURKE, SHARON S (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:S
Last Name:BURKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3700 W 203RD ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1180
Mailing Address - Country:US
Mailing Address - Phone:708-748-5202
Mailing Address - Fax:708-748-7305
Practice Address - Street 1:3700 W 203RD ST
Practice Address - Street 2:SUITE 103
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1180
Practice Address - Country:US
Practice Address - Phone:708-748-5202
Practice Address - Fax:708-748-7305
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2008-02-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE18962Medicare UPIN
IL0630600001Medicare NSC
IL207915Medicare PIN