Provider Demographics
NPI:1316177587
Name:SHARMA, ANKUR (MD)
Entity type:Individual
Prefix:DR
First Name:ANKUR
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 THEODORE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435
Mailing Address - Country:US
Mailing Address - Phone:815-744-5550
Mailing Address - Fax:815-744-5428
Practice Address - Street 1:4150 V ST
Practice Address - Street 2:SUITE 3500
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1460
Practice Address - Country:US
Practice Address - Phone:916-734-3014
Practice Address - Fax:916-734-7920
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA119014207R00000X
MIL1501570390200000X
IL036.134375207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program