Individual
DR. ISHVER H DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5909 W 35TH ST, CICERO, IL 60804-4163
(708) 652-2040
(708) 652-0058
Mailing address
5909 W 35TH ST, CICERO, IL 60804-4163
(708) 652-2040
(708) 652-0058
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3649479
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003649479
BLUE SHIELD, IL
IL
05
—
036049479
—
IL
01
—
111910675
RAIL ROAD MEDICARE PIN
IL
01
—
277330
WELLCARE HMO
IL
01
—
3649479
STATE LICENSE
—
01
—
640
CHICAGO HEALTH SYSTEMS (CHS)
IL
Enumeration date
10/11/2006
Last updated
07/05/2012
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