Basic Information
Provider Information
NPI: 1821483470
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHERMAN
FirstName: CAITLIN
MiddleName: MARIE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 21 SHERWOOD DR
Address2:  
City: LINCOLNSHIRE
State: IL
PostalCode: 600693220
CountryCode: US
TelephoneNumber: 8473705816
FaxNumber:  
Practice Location
Address1: 6200 WILSHIRE BLVD STE 1010
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900485811
CountryCode: US
TelephoneNumber: 2532400530
FaxNumber: 4805463134
Other Information
ProviderEnumerationDate: 03/31/2015
LastUpdateDate: 10/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2084P0800XA146348CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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