Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 03613800 | IL |
NPI | 1164788741 |
---|---|
Provider Name | Lajja Desai |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2012 |
Last Update Date | 27/09/2016 |