Individual
JOHN A. SHARUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4201 W MEDICAL CENTER DR, EMERGENCY DEPARTMENT, MCHENRY, IL 60050-8409
(815) 759-4546
Mailing address
4201 W MEDICAL CENTER DR, EMERGENCY DEPARTMENT, MCHENRY, IL 60050-8409
(815) 759-4546
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001331
IL
363AS0400X
Surgical Physician Assistant
085001331
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085001331
—
IL
01
—
9700013180
RAILROAD MEDICARE
IL
Enumeration date
09/27/2005
Last updated
03/14/2016
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