Healthcare Provider Details

I. General information

NPI: 1326201898
Provider Name (Legal Business Name): CHINTAN SAILESH DESAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2008
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 DELNOR DR
GENEVA IL
60134-4220
US

IV. Provider business mailing address

351 DELNOR DR
GENEVA IL
60134-4220
US

V. Phone/Fax

Practice location:
  • Phone: 630-232-0280
  • Fax: 630-232-3895
Mailing address:
  • Phone: 630-232-0280
  • Fax: 630-232-3895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125055385
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036127260
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: