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General NPI Number Information
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NPI Number | 1992050967
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Entity Type | Individual
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Provider Name | PUJA H. DESAI O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 1588 N ARLINGTON HEIGHTS RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-3906
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Country | US
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Telephone | 847-306-4477
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Fax |
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Provider Business Mailing Address
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Address Line | 1588 N ARLINGTON HEIGHTS RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-3906
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Country | US
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Telephone | 847-306-4477
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3881-35
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901005774
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046010565
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License Number State | IL
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