Individual
PAYAL DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1111 SUPERIOR ST, SUITE 104, MELROSE PARK, IL 60160-4138
(708) 486-2700
(800) 801-6284
Mailing address
1111 SUPERIOR ST, SUITE 104, MELROSE PARK, IL 60160-4138
(708) 486-2700
(800) 801-6284
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085003455
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085003455
STATE LICENSE
IL
Enumeration date
07/10/2009
Last updated
07/10/2009
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