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Individual

DR. BANSI D. SHARMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
17577 SOUTH KEDZIE AVE, SUITE 109, HAZEL CREST, IL 60429
(708) 799-1780
(708) 957-5150
Mailing address
17577 SOUTH KEDZIE AVE, SUITE 109, HAZEL CREST, IL 60429
(708) 799-1780
(708) 957-5150

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036051949
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036051949
IL
Enumeration date
05/19/2006
Last updated
11/22/2013
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