Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036139304 | IL |
N | 111NI0900X | Internist | 036139304 | IL |
N | 207RC0200X | Critical Care Medicine | 036139304 | IL |
Y | 207RP1001X | Pulmonary Disease | 036139304 | IL |
NPI | 1053576579 |
---|---|
Provider Name | Dr. Avani Tushar Mehta |
First Address | Skokie, IL 60076-1248 |
Second Address | Skokie, IL 60076-1248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2008 |
Last Update Date | 07/04/2021 |