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Individual

NISHA MEHTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1649 W CORTLAND ST, CHICAGO, IL 60622-8974
(574) 707-3359
Mailing address
777 N MICHIGAN AVE APT 3809, CHICAGO, IL 60611-6646
(574) 707-3359

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
019028352
IL
1223E0200X
Endodontics
Primary
021002599
IL

Other

Enumeration date
07/19/2010
Last updated
11/16/2017
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