Provider Demographics
NPI:1912280884
Name:MUHAMMAD, SHARON L (DT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:L
Last Name:MUHAMMAD
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14212 COTTAGE GROVE AVE UNIT 52
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-6004
Mailing Address - Country:US
Mailing Address - Phone:708-953-4605
Mailing Address - Fax:815-301-2677
Practice Address - Street 1:14212 COTTAGE GROVE AVE UNIT 52
Practice Address - Street 2:
Practice Address - City:DOLTON
Practice Address - State:IL
Practice Address - Zip Code:60419-6004
Practice Address - Country:US
Practice Address - Phone:708-953-4605
Practice Address - Fax:815-301-2677
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist