Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MITUL B. MODI, MD
Active Sole ProprietorMITUL B. MODI, MD is a Dermatology healthcare provider located in MAYWOOD, Illinois. NPI 1649794876 is currently active in the NPPES registry. Verify at CMS.
Dermatology · MAYWOOD, IL
Registration Details
- NPI Number
- 1649794876
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 31, 2017 (9.0499220019668 yrs)
- Last Updated
- Jan 16, 2025
- Licenses
-
125079219 (IL)036164764 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2160 S 1ST AVEMAYWOOD, IL, 601533328Browse IL providers · Browse ZIP 60153
- Phone
- 2488397383
- Primary Specialty
-
Dermatology
207N00000X
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Dermatology
Other Dermatology Providers in MAYWOOD, IL
| Name | Credential | NPI |
|---|---|---|
| EDGAR ANDERSON | MD | 1679550735 |
| JAMES SWAN | MD | 1316926140 |
| DR. LISSETTE CARMEN ORTIZ-FERRER | M.D. | 1609997998 |
| WENDY KIM | DO | 1790930477 |
| LAUREN MOY | M.D. | 1275997942 |
| DR. JENNA JANIGA LULLO | M.D. | 1376999821 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.