Individual
SANDEEP RAJAN MEHTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2405 N PARK AVE, INDIANAPOLIS, IN 46205-4563
(812) 219-0260
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11016597
IN
207RC0000X
Cardiovascular Disease Physician
Primary
036166061
IL
207RC0000X
Cardiovascular Disease Physician
A142868
CA
Other
Enumeration date
07/13/2012
Last updated
07/28/2023
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