Provider Demographics
NPI:1649567660
Name:NANGRANI, MEHAK D (DO)
Entity Type:Individual
Prefix:MS
First Name:MEHAK
Middle Name:D
Last Name:NANGRANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MEHAK
Other - Middle Name:
Other - Last Name:DHINGRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:370 E. CHICAGO ST,
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036
Mailing Address - Country:US
Mailing Address - Phone:515-279-5378
Mailing Address - Fax:515-279-5259
Practice Address - Street 1:4140 SOUTHWEST HIGHWAY
Practice Address - Street 2:
Practice Address - City:HOMETOWN
Practice Address - State:IL
Practice Address - Zip Code:60456
Practice Address - Country:US
Practice Address - Phone:708-422-5700
Practice Address - Fax:708-422-8225
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-059947207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine