Sharon Denise Fellingham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085001834 Issued in IL

Practice address

767 Park Ave West Suite #350
Park Ave. Associates in Internal Medicine
Highland Park, IL 60035

Phone

(773) 549-7757

NPI assigned

Mar 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Park Avenue Private Practice LLC

  • Health Service Clinic/Center
  • Highland Park, IL
  • NPI 1851763213
  Medicare reassignment

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1811965973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 PARK AVE WEST SUITE #350",
            "address_2": "PARK AVE. ASSOCIATES IN INTERNAL MEDICINE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "60035",
            "telephone_number": "847-926-4445",
            "fax_number": "847-681-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 PARK AVE WEST SUITE #350",
            "address_2": "PARK AVE. ASSOCIATES IN INTERNAL MEDICINE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "60035",
            "telephone_number": "773-549-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLINGHAM",
        "first_name": "SHARON",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "085001834",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Enid Fefer, LCSW
• Carolyn Feingold
• Ronald A Feingold, MD
• Shaseme Fejza, APN-CNP
• Robert R Feldman, PH.D.
• Stephen Fenchel, DDS
• Martha Ferry Biondi, PT
• Michelle Ann Field
• Fine Tuned Physical Therapy PLLC
• Ray Fiocchi Jr.

• Physician Assistant in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.