Individual provider Active NPI

Umang Sharma, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1952475436
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036121432 Issued in IL
Practice address
5359 W Fullerton Ave
Chicago, IL 60639-1450
Phone
(773) 836-2785
Fax
(773) 836-7381
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036121432 IL Primary
Family Medicine Physician 207Q00000X MD00045486 WA

Addresses

Primary practice location

5359 W Fullerton Ave
Chicago, IL 60639-1450

Mailing address

9119 S Exchange Ave
Chicago, IL 60617-4225
Phone (773) 768-5000

Other practice location 1

9119 S Exchange Ave
Chicago, IL 60617-4225
Phone (773) 768-5000

Other identifiers 2

IdentifierTypeStateIssuer
036121432OtherILSTATE LICENSE
MD00045486OtherWASTATE LICENCE

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
I20090204000185 IL Practitioner - Family PracticePractitioner - Internal Medicine 3577645894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Washington School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PCC Community Wellness CenterGroup PAC ID 1557270139, 91 clinicians

Practice addresses (Care Compare)

14 Lake St
Oak Park, IL 60302-2606
Phone 7083830113220005

3 Erie CT
Suite 1300
Oak Park, IL 60302-2519
Phone (708) 406-3929

5359 W Fullerton Ave
Chicago, IL 60639-1450
Phone 7083830113220005

5425 W Lake St
Chicago, IL 60644-2342
Phone (773) 413-1920

5461 W Lake St
Chicago, IL 60644-2342
Phone 7083830113220005

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PCC Community Wellness Center CurrentSince Nov 12, 2011 Accepting new patients
PCC Community Wellness Center CurrentSince Nov 12, 2011 Accepting new patients
PCC Community Wellness Center Past Accepting new patients

Locations

5359 W Fullerton Ave
Chicago, IL 60639
Phone (773) 836-2785

14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113

Organizations & group practices 3

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1952475436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9119 S EXCHANGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174225",
            "telephone_number": "773-768-5000",
            "fax_number": "773-768-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5359 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391450",
            "telephone_number": "773-836-2785",
            "fax_number": "773-836-7381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9119 S Exchange Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606174225",
            "country_code": "US",
            "telephone_number": "773-768-5000",
            "fax_number": "773-768-6153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "UMANG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2023-03-07",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036121432",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00045486",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036121432",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "MD00045486",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.