Individual
RAJ AJAY DESAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
272 S RANDALL RD, ALGONQUIN, IL 60102-9775
(858) 552-7525
Mailing address
205 S PEORIA ST APT 707, CHICAGO, IL 60607-3117
(848) 228-1848
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019.033372
IL
Other
Enumeration date
07/03/2018
Last updated
05/28/2022
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