Healthcare Provider Details

I. General information

NPI: 1114280682
Provider Name (Legal Business Name): USHA A. MEHTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W CERMAK RD # 3D
CHICAGO IL
60616-2268
US

IV. Provider business mailing address

600 W CERMAK RD # 3D
CHICAGO IL
60616-2268
US

V. Phone/Fax

Practice location:
  • Phone: 312-427-6000
  • Fax: 312-427-6001
Mailing address:
  • Phone: 312-427-6000
  • Fax: 312-427-6001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number036046244
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: