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NPI Code Detail

MEDICARE: SHANE SABNANI MEHTA LCPC

MEDICARE: SHANE SABNANI MEHTA LCPC
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
1101YP2500XProfessional Counselor180011698IL

General Provider Information

NPI Number : 1992276703
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANE SABNANI MEHTA LCPC
Provider Business Mailing Address
First Line : 737 N MICHIGAN AVE STE 2130
Second Line :
City : CHICAGO
State : IL
Zip : 60611-6747
Country : US
Telephone Number : 773-789-9775
Fax Number :
Provider Business Practice Location Address
First Line : 737 N MICHIGAN AVE STE 2130
Second Line :
City : CHICAGO
State : IL
Zip : 60611-6747
Country : US
Telephone Number : 773-789-9775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2018
Last Update Date : 12/06/2018

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Directions to “ SHANE SABNANI MEHTA LCPC” Practice Location

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