Provider Demographics
NPI:1831412816
Name:ALLEN, SHARON
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2746 N CLYBOURN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1006
Mailing Address - Country:US
Mailing Address - Phone:773-360-2052
Mailing Address - Fax:773-360-2070
Practice Address - Street 1:2746 N CLYBOURN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1006
Practice Address - Country:US
Practice Address - Phone:773-360-2052
Practice Address - Fax:773-360-2070
Is Sole Proprietor?:No
Enumeration Date:2010-03-05
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051038048183500000X, 1835P0018X
IN26018897A183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist