Healthcare Provider Details

I. General information

NPI: 1558584391
Provider Name (Legal Business Name): MEHBUB S KAPADIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W GRAND AVE STE 500
CHICAGO IL
60654-6799
US

IV. Provider business mailing address

6505 N LONGMEADOW AVE
LINCOLNWOOD IL
60712-3205
US

V. Phone/Fax

Practice location:
  • Phone: 800-325-1812
  • Fax:
Mailing address:
  • Phone: 773-338-8600
  • Fax: 773-338-7700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0001X
TaxonomyClinical & Laboratory Immunology (Internal Medicine) Physician
License Number336035459
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number336035459
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number336035459
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number336035459
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: