Provider Demographics
NPI:1245687565
Name:SHARMA, PRIYANKA (MD)
Entity type:Individual
Prefix:
First Name:PRIYANKA
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:, CLEO COUNTY, SECTOR 121,
Mailing Address - Street 2:APT 402, TOWER D2
Mailing Address - City:NOIDA
Mailing Address - State:UTTAR PRADESH
Mailing Address - Zip Code:201301
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3722 SOUTH HARLEM AVENUE SUITE LL34
Practice Address - Street 2:MACNEAL CENTER FOR INTERNAL MEDICINE
Practice Address - City:RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546
Practice Address - Country:US
Practice Address - Phone:708-783-6566
Practice Address - Fax:708-783-6567
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.068185207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine