Individual
MUKTESHWAR MEHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036046419
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020057300
BLACK LUNG PGA
IL
01
—
036046419
IL STATE LICENSE
IL
05
—
036046419
—
IL
01
—
08421024
BC/BS PGA
IL
01
—
133586700
ACS-OWCP PGA GROUP#
IL
01
—
14D0949277
CLIA PGA
IL
01
—
262941
HEALTHLINK
IL
01
—
330617
PERSONAL CARE
IL
01
—
6394P
CATERPILLAR PGA
IL
01
—
CD7143
PGA RR MEDICARE GROUP#
IL
01
—
P00453807
RR MED ID
IL
Enumeration date
05/19/2006
Last updated
10/01/2014
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