| Jehangir Mistry | |
|
2535 Bethany Rd Sycamore IL 60178-3126 | |
| (815) 756-6611 | |
| (815) 756-8441 |
| Full Name | Jehangir Mistry |
|---|---|
| Speciality | General Practice |
| Location | 2535 Bethany Rd, Sycamore, Illinois |
| Authorized Official Name and Position | Jehangir Mistry (OWNER) |
| Authorized Official Contact | 8157566611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jehangir Mistry 2535 Bethany Rd Sycamore IL 60178-3126 Ph: (815) 756-6611 | Jehangir Mistry 2535 Bethany Rd Sycamore IL 60178-3126 Ph: (815) 756-6611 |
| NPI Number | 1124392139 |
|---|---|
| Provider Enumeration Date | 03/08/2012 |
| Last Update Date | 03/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124392139 | NPI | - | NPPES |
| 02700116 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 036054240 (Illinois) | Primary |
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