Provider Demographics
NPI:1922361344
Name:MEHTA, DEVIN DHIREN (MD, MA)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:DHIREN
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 W RAND RD
Mailing Address - Street 2:
Mailing Address - City:MT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-1151
Mailing Address - Country:US
Mailing Address - Phone:847-725-8401
Mailing Address - Fax:847-618-5459
Practice Address - Street 1:199 W RAND RD STE 203
Practice Address - Street 2:
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-1157
Practice Address - Country:US
Practice Address - Phone:847-618-5450
Practice Address - Fax:847-618-5459
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036145754207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036145754OtherSTATE LICENSE