Individual
ANNU P MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-7698
(224) 610-7613
Mailing address
342 RAVINE RD, HINSDALE, IL 60521-3839
(224) 610-7698
(224) 610-7613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036133533
IL
207Q00000X
Family Medicine Physician
Primary
215928
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1947517-02
—
TX
05
—
2078040
—
MA
01
—
8BN840
BCBS
TX
Enumeration date
09/27/2006
Last updated
02/22/2024
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