AVINASH MANTHA MD NPI 1275952731

NPI Information

  • NPI: 1275952731
  • Provider Name: AVINASH MANTHA, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3046 127TH ST
    BLUE ISLAND, IL
    ZIP 60406
  • Phone: (708) 377-7920

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NPI Details

Avinash Mantha, MD is a family medicine in Blue Island, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Avinash Mantha, MD NPI is 1275952731. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3046 127TH ST
BLUE ISLAND, IL
ZIP 60406-827
Phone: (708) 377-7920
Fax: (708) 930-0414

The NPI 1275952731 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/14/2014 and was last updated on 10/30/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine036147326ILLINOISYes
2390200000XStudent in an Organized Health Care Education/Training ProgramNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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