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NPI Code Detail

MEDICARE: TWISHA DESAI RN,BSN

MEDICARE: TWISHA DESAI RN,BSN
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
1163W00000XRegistered Nurse041.490916IL

General Provider Information

NPI Number : 1619549250
Entity Type Code : Individual
Provider Name (Legal Business Name) : TWISHA DESAI RN,BSN
Provider Business Mailing Address
First Line : 2822 W CHICAGO AVE APT 2W
Second Line :
City : CHICAGO
State : IL
Zip : 60622-8964
Country : US
Telephone Number : 872-302-9113
Fax Number :
Provider Business Practice Location Address
First Line : 4021 W BELMONT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-4771
Country : US
Telephone Number : 773-328-5541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2021
Last Update Date : 07/13/2021

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