Healthcare Provider Details
I. General information
NPI: 1861468100
Provider Name (Legal Business Name): APURVA A DESAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/27/2006
Last Update Date: 10/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1710 N RANDALL RD STE 300
ELGIN IL
60123-9400
US
IV. Provider business mailing address
25070 NETWORK PL
CHICAGO IL
60673-1250
US
V. Phone/Fax
- Phone: 847-931-0909
- Fax: 847-488-9596
- Phone: 847-585-7000
- Fax: 847-240-0622
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 036097014 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: