Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036145754 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036145754 | IL |
NPI | 1922361344 |
---|---|
Provider Name | Dr. Devin Dhiren Mehta |
First Address | Mt Prospect, IL 60056-1151 |
Second Address | Mt Prospect, IL 60056-1157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2012 |
Last Update Date | 07/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036145754 | STATE LICENSE (01) | IL |