Individual
ELISABETH CLEARY SHEARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2434 INTERSTATE PLAZA DR, HAMMOND, IN 46324-2671
(219) 989-3700
(219) 845-4088
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01057583A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
036106782
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000647656
BC/BS
IN
01
—
01630255
BC/BC
IL
05
—
200440730
—
IN
01
—
297664
BC/BS
IN
01
—
351173213
ISPAT/INLAND
IN
01
—
5496757
CCN
IN
01
—
8126697
CIGNA
IN
01
—
P00816101
RAILROAD MEDICARE
IN
Enumeration date
08/25/2005
Last updated
01/23/2024
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