Provider Demographics
NPI:1700176450
Name:SHARIEFF, AMIN OMAR (MD)
Entity type:Individual
Prefix:DR
First Name:AMIN
Middle Name:OMAR
Last Name:SHARIEFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 BIENTERRA TRL
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-6616
Mailing Address - Country:US
Mailing Address - Phone:312-806-0262
Mailing Address - Fax:
Practice Address - Street 1:486 BIENTERRA TRL
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6616
Practice Address - Country:US
Practice Address - Phone:312-806-0262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036135165207RC0000X
IN01094171A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease