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NPI Code Detail

MEDICARE: PREMAL DESAI MD

MEDICARE: PREMAL DESAI MD
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
1207L00000XAnesthesiology Physician036175610IL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1972184554
Entity Type Code : Individual
Provider Name (Legal Business Name) : PREMAL DESAI MD
Provider Business Mailing Address
First Line : 2160 S 1ST AVE
Second Line :
City : MAYWOOD
State : IL
Zip : 60153-3328
Country : US
Telephone Number : 708-216-9000
Fax Number :
Provider Business Practice Location Address
First Line : 2950 CLEVELAND CLINIC BLVD
Second Line :
City : WESTON
State : FL
Zip : 33331-3609
Country : US
Telephone Number : 954-659-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2021
Last Update Date : 03/05/2026

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Directions to “ PREMAL DESAI MD” Practice Location

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