NPIMap

Organization Active NPI

Mrs Integrative Medicine LLC

  • Adult Medicine Physician
  • Warrenville, IL
National Provider Identifier
1770953986
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
036112797 Issued in IL
Legal business name
MRS INTEGRATIVE MEDICINE LLC
Practice address
3S630 Glen Dr S
Warrenville, IL 60555-3506
Phone
(248) 872-6963
NPI assigned
Sep 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Authorized official

Name
Dr. Ajay Sharma, D.O.
Title
Owner
Phone
(312) 266-8565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X 036112797 IL Primary

Addresses

Primary practice location

3S630 Glen Dr S
Warrenville, IL 60555-3506

Mailing address

3S630 Glen Dr S
Warrenville, IL 60555-3506
Phone (248) 872-6963

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1770953986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3S630 GLEN DR S",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553506",
            "telephone_number": "248-872-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3S630 GLEN DR S",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553506",
            "telephone_number": "248-872-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRS INTEGRATIVE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "AJAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-266-8565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IL",
            "license": "036112797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.