Provider Demographics
NPI:1104148972
Name:MEHTA, VIKAS (MD)
Entity type:Individual
Prefix:DR
First Name:VIKAS
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:LOYOLA UNIVERSITY MEDICAL CENTER, DEPT OF PATHOLOGY
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-327-2626
Mailing Address - Fax:708-327-2620
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:LOYOLA UNIVERSITY MEDICAL CENTER, DEPT OF PATHOLOGY
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-327-2626
Practice Address - Fax:708-327-2620
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2023-12-22
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Provider Licenses
StateLicense IDTaxonomies
IL125056310207ZP0102X
IL036130349207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology