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Organization

JEHANGIR MISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEHANGIR MISTRY M.D. (OWNER)
(815) 756-6611
Entity
Organization

Contact information

Practice address
2535 BETHANY RD, SYCAMORE, IL 60178-3126
(815) 756-6611
(815) 756-8441
Mailing address
2535 BETHANY RD, SYCAMORE, IL 60178-3126
(815) 756-6611
(815) 756-8441

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036054240
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02700116
IL
Enumeration date
03/08/2012
Last updated
03/08/2012
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