Provider Demographics
NPI:1003132549
Name:DESAI, VIKAS (MD)
Entity Type:Individual
Prefix:MR
First Name:VIKAS
Middle Name:
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-5916
Mailing Address - Country:US
Mailing Address - Phone:847-802-7090
Mailing Address - Fax:847-802-7095
Practice Address - Street 1:1465 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-5916
Practice Address - Country:US
Practice Address - Phone:847-802-7090
Practice Address - Fax:847-802-7095
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036140970208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology