MEDICARE: ASHESHA MECHINENI MD, FACP

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
1	207R00000X	Internal Medicine Physician	25MA09894100	NJ
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	036.155454	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659784817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHESHA MECHINENI MD, FACP

Provider Business Mailing Address
First Line	:	2242 W HARRISON ST STE 104
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3515
Country	:	US
Telephone Number	:	312-355-1091
Fax Number	:	312-413-0503

Provider Business Practice Location Address
First Line	:	2242 W HARRISON ST STE 104
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3515
Country	:	US
Telephone Number	:	312-355-1091
Fax Number	:	312-413-0503

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2014
Last Update Date	:	04/09/2025

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