Individual
SANJAY S MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W PARK ST, CARDIOLOGY, URBANA, IL 61801-2529
(217) 904-7000
(217) 904-7742
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801-2529
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036116289
IL
207RI0011X
Interventional Cardiology Physician
Primary
036116289
IL
Other
Enumeration date
07/18/2006
Last updated
01/06/2015
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