Individual
SUJAL DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036116885
IL
207X00000X
Orthopaedic Surgery Physician
Primary
036116885
IL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
20A9978
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036116885
STATE OF ILLINOIS LICENSE
IL
01
—
20A9978
CALIFORNIA STATE LICENSE#
CA
Enumeration date
09/22/2006
Last updated
03/10/2023
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