Provider Demographics
NPI:1649905050
Name:SHARMA, MALIKA (OD)
Entity type:Individual
Prefix:DR
First Name:MALIKA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 AUTUMNVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:WINNIPEG
Mailing Address - State:MANITOBA
Mailing Address - Zip Code:R3Y 0C6
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7208 191ST ST
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-9378
Practice Address - Country:US
Practice Address - Phone:815-464-0668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.011649152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist