Provider Demographics
NPI:1558584391
Name:KAPADIA, MEHBUB S (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHBUB
Middle Name:S
Last Name:KAPADIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6505 N LONGMEADOW AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3205
Mailing Address - Country:US
Mailing Address - Phone:773-338-8600
Mailing Address - Fax:773-338-7700
Practice Address - Street 1:2745 W DEVON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1712
Practice Address - Country:US
Practice Address - Phone:773-338-8600
Practice Address - Fax:773-338-7700
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL336035459207R00000X
IL036071671207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036071671Medicaid
IL206580Medicare ID - Type Unspecified