Organization
I.DESAI & R.GOKANI,M.D.,S.C.
Active
Other names
Personal Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ERIN MCCLEMENT (PRACTICE MANAGER)
(708) 652-2040
Entity
Organization
Contact information
Practice address
5909 W 35TH ST, CICERO, IL 60804-4163
(708) 652-2040
(708) 652-0058
Mailing address
5909 W 35TH ST, CICERO, IL 60804-4163
(708) 652-2040
(708) 652-0058
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021625882
BLUE CROSS & BLUE SHIELD
IL
01
—
CM8148
RR MEDICARE PIN
IL
Enumeration date
03/05/2007
Last updated
07/21/2022
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