Active NPI
Neel Mehta, PSY.D.
- Clinical Psychologist
- Palos Heights, IL
National Provider Identifier
1679059497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071009624
- Practice address
- 11800 S 75TH Ave FL 3
Palos Heights, IL 60463-1033 - Phone
- (708) 671-8440
- Fax
- (708) 671-8446
- NPI assigned
- Jul 15, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071009624 | IL | Primary |
Addresses
Primary practice location
11800 S 75TH Ave FL 3
Palos Heights, IL 60463-1033
Mailing address
55 Regent Dr
Oak Brook, IL 60523-1745
Phone (630) 915-0369
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071009624 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miracare Neuro Behavioral Health, PC | Multi-Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531612800000",
"number": "1679059497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 REGENT DR",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231745",
"telephone_number": "630-915-0369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11800 S 75TH AVE FL 3",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604631033",
"telephone_number": "708-671-8440",
"fax_number": "708-671-8446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHTA",
"first_name": "NEEL",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-15",
"last_updated": "2018-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071009624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palos Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.