Healthcare Provider Details

I. General information

NPI: 1518165471
Provider Name (Legal Business Name): MEHUL K. SHETH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 BRENTWOOD RD
NORTHBROOK IL
60062-6013
US

IV. Provider business mailing address

10000 W INNOVATION DR
MILWAUKEE WI
53226-4837
US

V. Phone/Fax

Practice location:
  • Phone: 847-513-9669
  • Fax:
Mailing address:
  • Phone: 414-456-5006
  • Fax: 414-456-6259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036115143
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: