Individual
DEEP SANJAY MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 ILLINI DR, PEORIA, IL 61605-2576
(309) 655-2000
Mailing address
1 ILLINI DR, PEORIA, IL 61605-2576
(309) 655-2000
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
125.085161
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/06/2021
Last updated
05/22/2025
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