Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 036140970 | IL |
NPI | 1003132549 |
---|---|
Provider Name | Mr. Vikas Desai |
First Address | Huntley, IL 60142-9582 |
Second Address | Huntley, IL 60142-9582 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2010 |
Last Update Date | 08/11/2021 |