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General NPI Number Information
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NPI Number | 1730160946
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Entity Type | Individual
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Provider Name | YASHBIR MEHTA MD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 95 N GREENLEAF ST
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City | GURNEE
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State | IL
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Zip | 60031-3309
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Country | US
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Telephone | 847-623-2114
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 379
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City | ORLAND PARK
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State | IL
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Zip | 60462-0379
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Country | US
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Telephone | 708-460-9833
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Fax | 708-460-1117
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 036044625
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License Number State | IL
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