Provider Demographics
NPI:1750481370
Name:DESAI, RUPA V (DO)
Entity Type:Individual
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First Name:RUPA
Middle Name:V
Last Name:DESAI
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Gender:F
Credentials:DO
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Mailing Address - Street 1:400 MCHENRY RD
Mailing Address - Street 2:TOWN CENTER SHOPPING CENTER
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6740
Mailing Address - Country:US
Mailing Address - Phone:847-520-9424
Mailing Address - Fax:847-520-9479
Practice Address - Street 1:9977 WOODS DR FL 1
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1057
Practice Address - Country:US
Practice Address - Phone:847-663-8420
Practice Address - Fax:847-663-1018
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2020-10-06
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Provider Licenses
StateLicense IDTaxonomies
IL036-087727207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF80291Medicare UPIN