Individual
MS. KINZIE G. SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2073 N CLYBOURN AVE, CHICAGO, IL 60614-4003
(773) 665-4106
(773) 360-6200
Mailing address
2073 N CLYBOURN AVE, CHICAGO, IL 60614-4003
(773) 665-4016
(773) 960-6200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004073
IL
Other
Enumeration date
07/21/2011
Last updated
11/04/2014
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