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Individual
MR. PRADEEP K MEHTA
Active
Individual
MR. PRADEEP K MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036-050314
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-050314
—
IL
01
—
036050314
BLUE CROSS BLUE SHIELD
—
01
—
136860
HEALTHLINK CIGNA
—
01
—
336-015704
IL CONTROLLED SUBSTANCE
IL
01
—
390002369
RAILROAD MEDICARE
—
01
—
44741
GHP
—
Enumeration date
02/03/2006
Last updated
03/07/2023
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