Provider Demographics
NPI:1700088234
Name:DESAI, SAPAN S (MD, PHD, MBA)
Entity type:Individual
Prefix:DR
First Name:SAPAN
Middle Name:S
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD, PHD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 W CENTRAL RD STE 5000
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2355
Mailing Address - Country:US
Mailing Address - Phone:847-618-3800
Mailing Address - Fax:847-618-3809
Practice Address - Street 1:880 W CENTRAL RD STE 5000
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2355
Practice Address - Country:US
Practice Address - Phone:847-618-3800
Practice Address - Fax:847-618-3809
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-134272208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036134272Medicaid
ILF400154909Medicare PIN