Individual
DR. JEHANGIR P MISTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2535 BETHANY ROAD, SUITE 107, SYCAMORE, IL 60178
(815) 756-6611
(815) 756-8441
Mailing address
2535 BETHANY ROAD, SUITE 107, SYCAMORE, IL 60178
(815) 756-6611
(815) 756-8441
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036054240
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001900112
BCBS
IL
05
—
036054240
—
IL
01
—
611489100
OWCP DOL
IL
Enumeration date
10/18/2006
Last updated
12/21/2009
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