Provider Demographics
NPI:1487015749
Name:KATZ, SHARON R (PT)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:R
Last Name:KATZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:R
Other - Last Name:MARCUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2524 W PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6077
Mailing Address - Country:US
Mailing Address - Phone:312-342-6305
Mailing Address - Fax:773-472-2935
Practice Address - Street 1:2524 W PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6077
Practice Address - Country:US
Practice Address - Phone:312-342-6305
Practice Address - Fax:773-472-2935
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.005361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist