MEDICARE: MR. JIGAR V DESAI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS38345	FL
2	183500000X	Pharmacist	5302032526	MI
3	183500000X	Pharmacist	051-288719	IL

General Provider Information

NPI Number	:	1295058865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JIGAR V DESAI

Provider Business Mailing Address
First Line	:	8118 N MILWAUKEE AVE
Second Line	:	SUITE 104
City	:	NILES
State	:	IL
Zip	:	60714-2817
Country	:	US
Telephone Number	:	847-518-0750
Fax Number	:

Provider Business Practice Location Address
First Line	:	8118 N MILWAUKEE AVE
Second Line	:	104
City	:	NILES
State	:	IL
Zip	:	60714-2817
Country	:	US
Telephone Number	:	847-518-0750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2010
Last Update Date	:	06/11/2020

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