Provider Demographics
NPI:1164124053
Name:DESAI, KHUSHBU PATEL (MSN,FNP-BC)
Entity Type:Individual
Prefix:
First Name:KHUSHBU
Middle Name:PATEL
Last Name:DESAI
Suffix:
Gender:F
Credentials:MSN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 NEWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-8014
Mailing Address - Country:US
Mailing Address - Phone:224-622-3171
Mailing Address - Fax:
Practice Address - Street 1:1833 NEWBERRY LN
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-8014
Practice Address - Country:US
Practice Address - Phone:224-622-3171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209025315363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care