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General NPI Number Information
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NPI Number | 1487678454
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Entity Type | Individual
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Provider Name | DINA DESAI M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 7050 S MADISON ST
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City | WILLOWBROOK
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State | IL
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Zip | 60527-5548
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Country | US
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Telephone | 630-889-8922
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Fax | 630-424-0021
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Provider Business Mailing Address
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Address Line | 7050 MADISON STREET
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City | WILLOWBROOK
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State | IL
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Zip | 60527-5548
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Country | US
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Telephone | 630-889-8922
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Fax | 630-424-0021
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036085129
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License Number State | IL
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