Individual
ASHINI DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5835 IL-154, PINCKNEYVILLE, IL 62274-2907
(803) 603-1585
Mailing address
1101 E GRAND AVE APT O12, CARBONDALE, IL 62901-3535
(803) 603-1585
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
085.008623
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/02/2021
Last updated
04/19/2022
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