Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 036-114090 | IL |
Y | 207VX0201X | Gynecologic Oncologist | 01065059A | IN |
N | 207VX0201X | Gynecologic Oncologist | 036-114090 | IL |
NPI | 1033278056 |
---|---|
Provider Name | Sameer Sharma |
First Address | Chicago, IL 60601-7514 |
Second Address | Dyer, IN 46311-1596 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 16/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I50813 | (02) | IL |