Provider Demographics
NPI:1639150972
Name:MAYANK Y. DOSHI M.D.S.C.
Entity type:Organization
Organization Name:MAYANK Y. DOSHI M.D.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYANK
Authorized Official - Middle Name:Y
Authorized Official - Last Name:DOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-774-2970
Mailing Address - Street 1:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-0379
Mailing Address - Country:US
Mailing Address - Phone:708-774-2970
Mailing Address - Fax:708-460-1117
Practice Address - Street 1:14544 JOHN HUMPHREY DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-2640
Practice Address - Country:US
Practice Address - Phone:708-460-7990
Practice Address - Fax:708-460-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31601676OtherBCBSIL GROUP #
IL486672Medicare ID - Type UnspecifiedGROUP #