Organization
KAILASH C. SHARMA MD SC
Active
Organization
KAILASH C. SHARMA MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAILASH C. SHARMA M.D. (PRESIDENT/OWNER)
(708) 687-4620
Entity
Organization
Contact information
Practice address
6360 159TH ST, SUITE A B, OAK FOREST, IL 60452-2725
(708) 687-4620
(708) 687-4625
Mailing address
7891 BROADWAY STE A, MERRILLVILLE, IN 46410-5556
(219) 756-3988
(219) 756-2595
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-094003
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036-094003
IL
207RP1001X
Pulmonary Disease Physician
Primary
036-094003
IL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
036-094003
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632588
BLUE SHIELD PPO #
IL
Enumeration date
05/12/2006
Last updated
04/14/2009
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