Individual
MEENAKSHI M DESAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD FACS
Contact information
Practice address
3000 BROADWAY, MT VERNON, IL 62864-0020
(618) 244-3200
(618) 244-3254
Mailing address
PO BOX 986, MT VERNON, IL 62864-2340
(618) 244-3200
(618) 244-3254
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036053115
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053115
—
IL
01
—
109262
HEALTHLINK
IL
01
—
4100079
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/25/2006
Last updated
02/06/2014
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