MUKTESHWAR MEHRA (NPI# 1699728584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699728584 |
| Entity Type | Individual |
| Full Name | MUKTESHWAR MEHRA |
| Other Name | M L MEHRA |
| Credential | MD |
| Practice Address |
2901 Old Jacksonville Rd Springfield IL 62704-7437 |
| Mailing Address |
Po Box 500 Chatham IL 62629-0500 |
| Practice Telephone | 2176989722 |
| Practice Fax Number | 2173910392 |
| Mailing Telephone | 2176989722 |
| Mailing Fax Number | 2173910392 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2014-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
036046419 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | HEALTHLINK | 262941 | 01 |
| IL | IL STATE LICENSE | 036046419 | 01 |
| IL | BC/BS PGA | 08421024 | 01 |
| IL | CLIA PGA | 14D0949277 | 01 |
| IL | BLACK LUNG PGA | 020057300 | 01 |
| IL | ACS-OWCP PGA GROUP# | 133586700 | 01 |
| IL | PGA RR MEDICARE GROUP# | CD7143 | 01 |
| IL | CATERPILLAR PGA | 6394P | 01 |
| IL | PERSONAL CARE | 330617 | 01 |
| IL | 036046419 | 05 | |
| IL | RR MED ID | P00453807 | 01 |
| Street Address |
2901 OLD JACKSONVILLE RD |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-7437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467441550 | Julio Cesar Vijil Sr. | Surgery | 2901 Old Jacksonville Rd, Suite B3, Springfield, IL 62704-7439 | 2005-10-20 |
| 1316591761 | Shelby Kern | Nurse Practitioner | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2019-07-24 |
| 1609392091 | Tamara Hardwick | Nurse Practitioner | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2017-08-17 |
| 1598217978 | Amy J Welch | Registered Nurse | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2016-11-01 |
| 1316399140 | Neesha Settipalle | Internal Medicine | 2901 Old Jacksonville Rd, Springfield, IL 62704 | 2016-07-05 |
| 1508245028 | Carly Ellison | Nurse Practitioner | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2015-05-29 |
| 1013395250 | Gopinathan Gangadharan Nambiar | Pediatrics | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2015-05-07 |
| 1467849257 | Hshs Medical Group Inc | Durable Medical Equipment & Medical Supplies | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2015-04-20 |
| 1225443484 | Erin Blackburn | Pediatrics | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2014-06-26 |
| 1801209291 | Jieun Heo | Family Medicine | 2901 Old Jacksonville Rd, Springfield, IL 62704-7437 | 2014-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750941639 | Ammar Tarabichi | Psychiatry & Neurology | 751 N Rutledge, Springfield, Il, Springfield, IL 62794 | 2019-06-13 |
| 1316441470 | Earl Randolph Hackett | Psychiatry & Neurology | 2517 S. Brentwood, Springfield, MO 65804-3201 | 2018-03-22 |
| 1336668326 | Western Mass Neurology PC | Psychiatry & Neurology | 175 Carew St Ste 140, Springfield, MA 01104-2389 | 2017-09-12 |
| 1407111313 | Pavan Tummala | Psychiatry & Neurology | 3800 S National Ave Ste 900, Springfield, MO 65807-5209 | 2012-07-06 |
| 1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
| 1053553560 | Quantum Total Health | Psychiatry & Neurology | 607 S Locust St, Springfield, TN 37172 | 2009-03-30 |
| 1154513687 | Fazeel Mukhtar Siddiqui | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2007-08-17 |
| 1164593646 | Michael Balm | Psychiatry & Neurology | 1 Hayden Bridge Way Ste 410, Springfield, OR 97477-1347 | 2006-11-13 |
| 1881638591 | Rodney D Quinn | Psychiatry & Neurology | 3801 S National Ave # 900, Springfield, MO 65807-5210 | 2006-06-15 |
| 1750332771 | Sleep Medicine Services of Western Massachusetts LLC | Psychiatry & Neurology | 3640 Main St Ste 208, Springfield, MA 01107-1192 | 2006-05-15 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
Please comment or provide details below to improve the information on MUKTESHWAR MEHRA.
| 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.