Provider Demographics
NPI:1205123841
Name:MEHTA, KARTIK B (DO)
Entity type:Individual
Prefix:DR
First Name:KARTIK
Middle Name:B
Last Name:MEHTA
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1302 FRANKLIN AVE STE 4500
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-3593
Mailing Address - Country:US
Mailing Address - Phone:309-556-8300
Mailing Address - Fax:309-556-8293
Practice Address - Street 1:1302 FRANKLIN AVE STE 4500
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-3593
Practice Address - Country:US
Practice Address - Phone:309-556-8300
Practice Address - Fax:309-556-8293
Is Sole Proprietor?:No
Enumeration Date:2011-07-04
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
IL036142268207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease