Individual
KRISTEN MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC
Contact information
Practice address
225 E CHICAGO AVE, BOX #29, CHICAGO, IL 60611-2991
(312) 227-4000
Mailing address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209014075
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209014075
209014075
IL
Enumeration date
04/04/2016
Last updated
01/05/2017
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