Individual provider Active NPI

Anjali Hemu Mehta, M.D.

  • Rheumatology Physician
  • Chicago, IL
National Provider Identifier
1366624819
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036-12828 Issued in IL
Practice address
1819 W Polk St Ste A312
Division of Rheumatology, MC 733
Chicago, IL 60612-4356
Phone
(312) 413-9310
NPI assigned
Nov 27, 2007
Last updated
Sep 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.013938 OH
Internal Medicine Physician 207R00000X 35.094770 OH
Internal Medicine Physician 207R00000X 036-128280 IL
Rheumatology Physician 207RR0500X 164564 OR
Rheumatology Physician 207RR0500X 036-12828 IL Primary

Addresses

Primary practice location

1819 W Polk St Ste A312
Division of Rheumatology, MC 733
Chicago, IL 60612-4356

Mailing address

1801 W. Polk Street, A312
Division of Rheumatology (Mc733)
Chicago, IL 60612
Phone (312) 413-9310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150825005606 IL Practitioner - Internal MedicinePractitioner - Rheumatology 4183806326 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-128280ILMDInternal Medicine Physician
35.094770OHMDInternal Medicine Physician
57.013938OHMDInternal Medicine Physician
036-12828ILMDRheumatology Physician
164564ORMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jun 1, 2015 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Internal Medicine CurrentSince Jun 1, 2015 Accepting new patients

Locations

1819 W Polk St
Ste A312
Chicago, IL 60612
Phone (312) 413-9310

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

840 S Wood St
#787
Chicago, IL 60612
Phone (312) 413-8687

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1366624819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W. POLK STREET, A312",
            "address_2": "DIVISION OF RHEUMATOLOGY (MC733)",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-413-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 W POLK ST STE A312",
            "address_2": "DIVISION OF RHEUMATOLOGY, MC 733",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124356",
            "telephone_number": "312-413-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "ANJALI",
        "middle_name": "HEMU",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.013938",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.094770",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-128280",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OR",
            "license": "164564",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036-12828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.