Healthcare Provider Details

I. General information

NPI: 1265609739
Provider Name (Legal Business Name): MEHUL PRAVIN SONI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 E NORTHWEST HWY STE 200
DES PLAINES IL
60016-2274
US

IV. Provider business mailing address

380 E NORTHWEST HWY STE 200
DES PLAINES IL
60016-2274
US

V. Phone/Fax

Practice location:
  • Phone: 847-813-0700
  • Fax:
Mailing address:
  • Phone: 847-813-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036126485
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036126485
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number036126485
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: