Provider Demographics
NPI:1790089456
Name:DESAI, VISHVA MANMATHDEV (DC)
Entity Type:Individual
Prefix:DR
First Name:VISHVA
Middle Name:MANMATHDEV
Last Name:DESAI
Suffix:
Gender:F
Credentials:DC
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Mailing Address - Street 1:80 WEST HILLCREST BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60195
Mailing Address - Country:US
Mailing Address - Phone:630-339-5300
Mailing Address - Fax:630-339-5305
Practice Address - Street 1:80 WEST HILLCREST BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195
Practice Address - Country:US
Practice Address - Phone:630-339-5300
Practice Address - Fax:630-339-5305
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL038011857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor