Provider Demographics
NPI:1730160946
Name:MEHTA, YASHBIR (MD)
Entity type:Individual
Prefix:DR
First Name:YASHBIR
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-0379
Mailing Address - Country:US
Mailing Address - Phone:708-460-9833
Mailing Address - Fax:708-460-1117
Practice Address - Street 1:95 N GREENLEAF ST
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3309
Practice Address - Country:US
Practice Address - Phone:847-623-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360446252085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01633381OtherBCBSIL ADVANCED RAD
1548251986OtherADV RAD NPI #
IL04932214OtherBCBSIL ROTATING GAMMA
1902897358OtherROT GMA NPI#
IL920007667OtherRR MEDICARE ADVANCED RAD
ILP00042095OtherRR MEDICARE ROT GMA
ILCK9135OtherRR MEDICARE ADV RAD GR#
IL036044625Medicaid
ILDA2626OtherRR MEDICARE ROT GMA GR#
IL036044625Medicaid
IL04932214OtherBCBSIL ROTATING GAMMA