Basic Information
| Provider Information | |||||||||
| NPI: | 1326769076 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MEHUL VORA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10837 WARWICK LN | ||||||||
| Address2: | |||||||||
| City: | ORLAND PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604674603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7084607990 | ||||||||
| FaxNumber: | 7084607917 | ||||||||
| Practice Location | |||||||||
| Address1: | 14544 JOHN HUMPHREY DR | ||||||||
| Address2: | |||||||||
| City: | ORLAND PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604622640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7084607990 | ||||||||
| FaxNumber: | 7084607917 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2022 | ||||||||
| LastUpdateDate: | 09/09/2022 | ||||||||
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| AuthorizedOfficialLastName: | VORA | ||||||||
| AuthorizedOfficialFirstName: | MEHUL | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7084607990 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 09/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.