Individual
DR. SHAMIT SHAILENDRA DESAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 INGALLS DR, HARVEY, IL 60426-3558
(708) 915-5614
Mailing address
PO BOX 678678, DALLAS, TX 75267-8678
(800) 475-6112
(423) 826-1286
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
470981
PA
2085R0204X
Vascular & Interventional Radiology Physician
01082448A
IN
2085R0204X
Vascular & Interventional Radiology Physician
Primary
036139638
IL
2085R0204X
Vascular & Interventional Radiology Physician
470981
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT203607
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103767757
—
PA
01
—
1102298847
ANTHEM
IN
05
—
300058984
—
IN
Enumeration date
06/25/2013
Last updated
11/22/2024
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