Provider Demographics
NPI:1982672549
Name:BERLIANT, SHARON D (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:D
Last Name:BERLIANT
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 1:9555 GROSS POINT RD
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1356
Mailing Address - Country:US
Mailing Address - Phone:847-291-7750
Mailing Address - Fax:
Practice Address - Street 1:9555 GROSS POINT RD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1356
Practice Address - Country:US
Practice Address - Phone:847-291-7750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036076464207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036076464Medicaid
ILE70011Medicare UPIN
IL036076464Medicaid