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General NPI Number Information
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NPI Number | 1871873885
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Entity Type | Organization
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Legal Business Name | OAKBROOK PRIMARY CARE
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 17 WEST 755 BUTTERFIELD ROAD SUITE NO 103
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-4253
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Country | US
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Telephone | 630-889-8922
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Fax |
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Provider Business Mailing Address
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Address Line | 17 WEST 755 BUTTERFIELD ROAD SUITE NO 103
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-4253
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Country | US
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Telephone | 630-889-8922
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Fax | 639-889-8953
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Authorized Official
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Title or Position | M.D./OWNER
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Name | DR. DINA DESAI
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Credential | M.D.
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Telephone | 630-889-8922
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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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