Provider Demographics
NPI:1861468100
Name:DESAI, APURVA A (MD)
Entity Type:Individual
Prefix:DR
First Name:APURVA
Middle Name:A
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:25070 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1250
Mailing Address - Country:US
Mailing Address - Phone:847-585-7000
Mailing Address - Fax:847-240-0622
Practice Address - Street 1:1710 N RANDALL RD
Practice Address - Street 2:STE 300
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-9400
Practice Address - Country:US
Practice Address - Phone:847-931-0909
Practice Address - Fax:847-488-9596
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036097014207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036097014Medicaid
ILF400115214Medicare PIN
ILF400115213Medicare PIN
ILF400115212Medicare PIN