Desai, Tina R.
Desai, Tina R. is an individual health care provider with primary practice located at 5841 S Maryland Ave , Chicago IL 60637-1447. She recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as her primary health care specialty. Desai, Tina R. can be contacted via phone (773) 702-6128.Contact Information
Primary practice address
5841 S Maryland Ave
Chicago IL 60637-1447
Phone: (773) 702-6128
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 036087065 | Illinois |
Profile Details
| NPI number | 1629147897 |
|---|---|
| LBN Legal business name | Desai, Tina R. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 6th, 2006 |
| Last updated | Feb 19th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629147897 | NPPES |
| Illinois | Other | 036-087065 | STATE LICENSE |
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