Individual provider Active NPI

Sharon W Glickman, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1770816431
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.007541 Issued in IL
Practice address
2266 N Lincoln Ave
3Rd Floor
Chicago, IL 60614-7600
Phone
(847) 373-1753
NPI assigned
Sep 14, 2009
Last updated
Apr 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.007541 IL Primary

Addresses

Primary practice location

2266 N Lincoln Ave
3Rd Floor
Chicago, IL 60614-7600

Mailing address

9011 Pottawattami Dr
Skokie, IL 60076-1909
Phone (847) 674-7978

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100212000535 IL Practitioner - Nurse Practitioner 3476697517 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.007541ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Raja Gill SC CurrentSince May 1, 2013 Accepting new patients
Paragon Clinical Midwest, LLC Past Accepting new patients

Locations

2266 N Lincoln Ave
Ste 3
Chicago, IL 60614
Phone (773) 327-8008

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1770816431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9011 POTTAWATTAMI DR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761909",
            "telephone_number": "847-674-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 N LINCOLN AVE",
            "address_2": "3RD FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147600",
            "telephone_number": "847-373-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKMAN",
        "first_name": "SHARON",
        "middle_name": "W",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-14",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.007541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.