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NPI Code Detail

MEDICARE: MRS. MUKUNDINI S MEHTA MD

MEDICARE: MRS. MUKUNDINI S MEHTA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207VG0400XGynecology Physician36059220IL
2207V00000XObstetrics & Gynecology Physician363659220IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3160025319OTHERILRR MEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11411OTHERILCHICAGO HEALTH SERVICES (CHS) PIN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
431603182OTHERILBCBS

General Provider Information

NPI Number : 1154303584
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MUKUNDINI S MEHTA MD
Provider Business Mailing Address
First Line : 5909 W 35TH ST
Second Line :
City : CICERO
State : IL
Zip : 60804-4163
Country : US
Telephone Number : 708-652-2040
Fax Number : 708-652-0058
Provider Business Practice Location Address
First Line : 5909 W 35TH ST
Second Line :
City : CICERO
State : IL
Zip : 60804-4163
Country : US
Telephone Number : 708-652-2040
Fax Number : 708-652-0058
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 01/11/2024

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Directions to “ MRS. MUKUNDINI S MEHTA MD” Practice Location

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