Provider Demographics
NPI:1093963738
Name:MEHTA, RUPAL C (MD)
Entity Type:Individual
Prefix:DR
First Name:RUPAL
Middle Name:C
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:633 N SAINT CLAIR ST
Mailing Address - Street 2:18TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3234
Mailing Address - Country:US
Mailing Address - Phone:312-503-1536
Mailing Address - Fax:312-503-5656
Practice Address - Street 1:633 N SAINT CLAIR ST
Practice Address - Street 2:18TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3234
Practice Address - Country:US
Practice Address - Phone:312-503-1536
Practice Address - Fax:312-503-5656
Is Sole Proprietor?:No
Enumeration Date:2008-09-06
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHUNKNOWN207R00000X
IL036.129948207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine