Healthcare Provider Details

I. General information

NPI: 1346774940
Provider Name (Legal Business Name): NEHA MEHTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date: 07/11/2017
Reactivation Date: 08/15/2017

III. Provider practice location address

1 KISH HOSPITAL DR
DEKALB IL
60115-9602
US

IV. Provider business mailing address

801 5TH ST
SIOUX CITY IA
51101-1326
US

V. Phone/Fax

Practice location:
  • Phone: 815-756-1521
  • Fax: 815-748-5789
Mailing address:
  • Phone: 712-279-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-46727
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036180134
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: