Provider Demographics
NPI:1043269210
Name:KESANI, AJIT KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:AJIT
Middle Name:KUMAR
Last Name:KESANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 AUSTIN ST
Mailing Address - Street 2:ST. FRANCIS PROFESSIONAL BUILDING, WEST TOWER SUITE 503
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3439
Mailing Address - Country:US
Mailing Address - Phone:847-864-5550
Mailing Address - Fax:847-864-5551
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:ST. FRANCIS PROFESSIONAL BUILDING, WEST TOWER SUITE 503
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3439
Practice Address - Country:US
Practice Address - Phone:847-864-5550
Practice Address - Fax:847-864-5551
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-101210207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-101210OtherMEDICAL LICENSE
H40408Medicare UPIN