Individual
BRINDA MUKESH MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
530 NE GLEN OAK AVE, UICOMP/DEPT. OF PEDIATRICS OSF NORTH BLDG. ROOM 5642, PEORIA, IL 61637
(309) 655-4746
(309) 655-2565
Mailing address
530 NE GLEN OAK AVENUE, UICOMP DEPT OF PEDIATRICS, OSF NORTH BLDG. ROOM 5642, PEORIA, IL 61637
(309) 655-4746
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
01074184A
IN
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
036.142777
IL
390200000X
Student in an Organized Health Care Education/Training Program
BP10039198
TX
Other
Enumeration date
05/15/2012
Last updated
03/17/2018
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