Provider Demographics
NPI:1376758383
Name:MEHTA, VIRAL D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VIRAL
Middle Name:D
Last Name:MEHTA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 DANSFORTH DR
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2870
Mailing Address - Country:US
Mailing Address - Phone:847-891-0851
Mailing Address - Fax:
Practice Address - Street 1:218 DANSFORTH DR
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-2870
Practice Address - Country:US
Practice Address - Phone:847-891-0851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist