Provider Demographics
NPI:1659784817
Name:MECHINENI, ASHESHA (MD, FACP)
Entity type:Individual
Prefix:
First Name:ASHESHA
Middle Name:
Last Name:MECHINENI
Suffix:
Gender:
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2242 W HARRISON ST STE 104
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3515
Mailing Address - Country:US
Mailing Address - Phone:312-355-1091
Mailing Address - Fax:312-413-0503
Practice Address - Street 1:2242 W HARRISON ST STE 104
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3515
Practice Address - Country:US
Practice Address - Phone:312-355-1091
Practice Address - Fax:312-413-0503
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09894100207R00000X
IL036.155454207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0542717Medicaid
NJ541975P53Medicare PIN