Provider Demographics
NPI:1568433845
Name:DESAI, RAMESH H (MD)
Entity Type:Individual
Prefix:
First Name:RAMESH
Middle Name:H
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 1:2015 N MAIN STREET
Mailing Address - Street 2:DUPAGE EYE SURGERY CENTER
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187
Mailing Address - Country:US
Mailing Address - Phone:630-665-3690
Mailing Address - Fax:630-665-3686
Practice Address - Street 1:2015 N MAIN STREET
Practice Address - Street 2:DUPAGE EYE SURGERY CENTER
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187
Practice Address - Country:US
Practice Address - Phone:630-665-3690
Practice Address - Fax:630-665-3686
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36075567207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36075567Medicaid
545600Medicare ID - Type Unspecified
IL36075567Medicaid