Mitul Modi, MD
Dermatologist in Maywood, IL
Registered providerLicense # listed (IL)
Public-record details
- Address
- 2160 S 1st Ave, Maywood, IL 60153
- Phone
- (248) 839-7383
- Listed under
- Individual clinicians
- NPI
- 1649794876
- NPI status
- Active in the NPPES registry
- Provider type
- Individual provider
- Registered specialty (self-reported taxonomy)
- Dermatology (207N00000X)
- Credentials listed
- MD
- License number on NPI record
- 036164764 (IL)
- NPI first issued
- Jul 31, 2017
- Years since NPI first issued
- 9 years (since 2017)
- License state on NPI record
- IL
- NPI record last updated
- Jan 16, 2025
- Other practice locations (NPPES)
- 1: Philadelphia, PA
- Other dermatology listings at this street address
- 18
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What these registry facts mean
Practices and clinicians at this address
Registered specialty is not board certification. Verify the license with the state medical board and board certification with the American Board of Dermatology or the American Osteopathic Board of Dermatology. Ask whether the practice takes your insurance or Medicare plan before you book.