Individual ProviderSharon Marie SoutheEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address1901 W Harrison St, Chicago, IL 60612-3714(312) 864-6000(773) 651-0981PECOS EnrollmentBased on the most recent information from CMS, provider Sharon Marie Southe does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1578631222Provider TypeIndividualFull NameSouthe, Sharon MarieTitleDr.CredentialM. D.GenderFemaleSole ProprietorNoEnumeration Date12/1/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address1901 W Harrison St, Chicago, IL 60612-3714Phone(312) 864-6000Fax(312) 864-9656Mailing LocationMailing Address8138a S. Prairie Ave., Chicago, IL 60619-4808Phone(773) 651-0981FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicense36-62854IllinoisProvider IdentifiersIDDescriptionIssuerID36-62854DescriptionOtherIssuerSTATE MEDICAL LISCENCEIllinois