Provider Demographics
NPI:1306270152
Name:SHARAIN, ROSALIND F (MD)
Entity type:Individual
Prefix:
First Name:ROSALIND
Middle Name:F
Last Name:SHARAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROSALIND
Other - Middle Name:
Other - Last Name:SANDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:28100 N ASHLEY CIR STE 106
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-9478
Mailing Address - Country:US
Mailing Address - Phone:847-996-1030
Mailing Address - Fax:
Practice Address - Street 1:28100 N ASHLEY CIR STE 106
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-9478
Practice Address - Country:US
Practice Address - Phone:847-996-1030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN58198207ZP0102X, 207ZP0105X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH400161525Medicare PIN