Provider Demographics
NPI:1851970180
Name:MEHTA, AMAR (PA-C)
Entity type:Individual
Prefix:
First Name:AMAR
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 N LAKE SHORE DR APT 911
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3402
Mailing Address - Country:US
Mailing Address - Phone:312-802-5594
Mailing Address - Fax:
Practice Address - Street 1:1585 N BARRINGTON RD STE 101
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5019
Practice Address - Country:US
Practice Address - Phone:847-884-7771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant