Individual provider Active NPI

Rekha Sharma, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Hazel Crest, IL
National Provider Identifier
1619054228
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
36-095503 Issued in IL
Practice address
3330 W 177TH St
Suite 2E
Hazel Crest, IL 60429-2184
Phone
(708) 799-5455
Fax
(708) 799-5736
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 36-095503 IL Primary

Addresses

Primary practice location

3330 W 177TH St
Suite 2E
Hazel Crest, IL 60429-2184

Mailing address

3330 W 177TH St
Suite 2E
Hazel Crest, IL 60429-2184
Phone (708) 799-5455

Other identifiers 1

IdentifierTypeStateIssuer
36095503OtherILLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031121000553 IL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 1557265402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3330 W 177TH St
Suite 2E
Hazel Crest, IL 60429-2192
Phone (708) 799-5455

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36-095503ILMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geri-Med Service LTD Geriatric Medicine CurrentSince May 1, 2006 Accepting new patients
Advocate Health Centers, Inc. Past Accepting new patients

Locations

3330 W 177th St
Ste 2E
Hazel Crest, IL 60429
Phone (708) 275-9669

17800 Kedzie Ave
Hazel Crest, IL 60429
Phone (708) 213-4200

3330 W 177th St
Hazel Crest, IL 60429
Phone (708) 249-8347

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJADCA/Endpoint/BJADCA

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1619054228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "SUITE 2E",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "708-799-5455",
            "fax_number": "708-799-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "SUITE 2E",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292184",
            "telephone_number": "708-799-5455",
            "fax_number": "708-799-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "REKHA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "36-095503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "36095503",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

Verify at the official NPI Registry.