Modi, Mitul B.

Modi, Mitul B. is an sole proprietor health care provider with primary practice located at 2160 S 1St Ave , Maywood IL 60153-3328. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatopathology is his primary health care specialty. Modi, Mitul B. can be contacted via phone (248) 839-7383.

Contact Information

Primary practice address
2160 S 1St Ave Maywood IL 60153-3328
Phone: (248) 839-7383
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Dermatopathology 207ZD0900X 125079219 Illinois

Profile Details

NPI number 1649794876
LBN Legal business name Modi, Mitul B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2017
Last updated May 18th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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