Provider Demographics
NPI:1871095547
Name:MEHTA, BINOLI HARDIK
Entity type:Individual
Prefix:MRS
First Name:BINOLI
Middle Name:HARDIK
Last Name:MEHTA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:BINOLI
Other - Middle Name:HARSHADKUMAR
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 WESTBROOK CORPORATE CTR
Mailing Address - Street 2:STE 240
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5745
Mailing Address - Country:US
Mailing Address - Phone:708-236-2600
Mailing Address - Fax:708-409-5179
Practice Address - Street 1:1303 BAYOU PATH CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3609
Practice Address - Country:US
Practice Address - Phone:224-532-8485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.023512225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist