Provider Demographics
NPI:1952677791
Name:MEHTA, SARITA (PA-C)
Entity Type:Individual
Prefix:
First Name:SARITA
Middle Name:
Last Name:MEHTA
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:555 W MONROE ST
Mailing Address - Street 2:EMPLOYEE HEALTH AND WELLNESS CENTER SUITE 3N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-3605
Mailing Address - Country:US
Mailing Address - Phone:312-821-2910
Mailing Address - Fax:312-821-3114
Practice Address - Street 1:555 W MONROE ST
Practice Address - Street 2:EMPLOYEE HEALTH AND WELLNESS CENTER SUITE 3N
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-3605
Practice Address - Country:US
Practice Address - Phone:312-821-2910
Practice Address - Fax:312-821-3114
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2014-01-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant