SHILPA MEHTA (NPI# 1407162530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407162530 |
| Entity Type | Individual |
| Full Name | SHILPA MEHTA |
| Credential | M.D. |
| Practice Address |
1900 W Polk St Chicago IL 60612-3723 |
| Mailing Address |
100 E 14th St Apt 1001 Chicago IL 60605-3666 |
| Practice Telephone | 3128646000 |
| Mailing Telephone | 8475960356 |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2020-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 036-128502 | IL | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 125053959 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518447945 | Shilpa Mehta | Clinic/Center | 4190 24th Ave Ste 205, Fort Gratiot, MI 48059-3884 | 2018-08-15 |
| 1548422991 | Shilpa J. Mehta | Internal Medicine | 100 E Valencia Mesa Dr Ste 105, Fullerton, CA 92835 | 2008-06-26 |
| 1255743365 | Shilpa Mehta | Pediatrics | 1 Brookdale Plz, Brooklyn, NY 11212-3139 | 2014-05-22 |
| 1487742730 | Shilpa Shamik Mehta | Dentist | 5130 Stevens Creek Blvd, San Jose, CA 95129-1019 | 2006-10-11 |
| 1174616411 | Shilpa Mehta | Family Medicine | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2006-10-01 |
| 1427153337 | Shilpa Mehta | Radiology | 1555 Barrington Rd, Hoffman Estates, IL 60194-1019 | 2006-09-14 |
| 1447236773 | Shilpa Prabodh Mehta | Internal Medicine | 1400 Peoples Plz, Suite 201, Newark, DE 19702-5707 | 2005-12-19 |
| 1144212671 | Shilpa P. Mehta | Pathology | 1775 Dempster St, Lutheran General Hospital / Pathology Department, Park Ridge, IL 60068-1143 | 2005-08-19 |
| Street Address |
1900 W POLK ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861478893 | Steven R Bonomo | Surgery | 1900 W Polk St, Chicago, IL 60612-3723 | 2005-12-21 |
| 1679182760 | Aruna N Sasikumar | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2020-07-24 |
| 1174144810 | Chelsae L May | Student in an Organized Health Care Education/Training Program | 1900 W Polk St, Chicago, IL 60612-3723 | 2020-05-05 |
| 1750930475 | Kimberly Rhodes | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-09-05 |
| 1992363584 | Rachel Elizabeth Earl | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-05-30 |
| 1356909949 | Marie Roman | Social Worker | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-05-30 |
| 1265090856 | Kristina Coenen | Counselor | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-05-30 |
| 1205396512 | Luisa Patricia Guerrero | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-03-22 |
| 1366902876 | Liza Patria Gaines | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-03-21 |
| 1629538137 | Courtney Jenkins | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114551983 | Katherine Janezic | Dermatology | 7447 W Talcott Ave Ste 425, Chicago, IL 60631-3704 | 2020-03-02 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1891257853 | Maria Estela Martinez Escala | Dermatology | 5841 S Maryland Ave Ste Mc5067, Chicago, IL 60637-1443 | 2019-04-01 |
| 1275013450 | Advanced Dermatology and Aesthetic Medicine | Dermatology | 850 S Wabash Ave Ste 200, Chicago, IL 60605-3642 | 2018-08-17 |
| 1346784543 | Dermio, LLC | Dermatology | 3023 N Clark St, Suite 861, Chicago, IL 60657-5200 | 2016-12-07 |
| 1366823544 | Oyinade Aderibigbe | Dermatology | 111 W Washington St Ste 1801, Chicago, IL 60602-3430 | 2015-06-14 |
| 1073909032 | Julia Dai | Dermatology | 5758 S Maryland Ave Fl 3, Chicago, IL 60637 | 2015-04-07 |
| 1437544582 | Nicholas Blickenstaff | Dermatology | 30 N Michigan Ave Ste 1429, Chicago, IL 60602-3698 | 2015-04-04 |
| 1801285929 | Medical Dermatology Associates of Chicago, Ltd | Dermatology | 363 W Erie St, Suite 350, Chicago, IL 60654-6903 | 2015-01-13 |
| 1366857286 | Noor Tazudeen | Dermatology | 4700 N Marine Dr Ste 220, Chicago, IL 60640-7972 | 2014-06-30 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.