Organization
HARSHAD M. MEHTA MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARSHAD M. MEHTA MD (PRESIDENT)
(708) 425-8900
Entity
Organization
Contact information
Practice address
2850 W. 95TH STREET, SUITE 206, EVERGREEN PARK, IL 60805
(708) 425-8900
(708) 425-9612
Mailing address
2850 W. 95TH STREET, SUITE 206, EVERGREEN PARK, IL 60805
(708) 425-8900
(708) 425-9612
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-51716
IL
2084P0802X
Addiction Psychiatry Physician
036-51716
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051716
—
IL
Enumeration date
04/03/2012
Last updated
04/03/2012
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