Provider Demographics
NPI:1235515669
Name:DESAI, URVISH B (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:URVISH
Middle Name:B
Last Name:DESAI
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1964 CHELTENHAM PL
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2406
Mailing Address - Country:US
Mailing Address - Phone:224-628-9728
Mailing Address - Fax:
Practice Address - Street 1:1964 CHELTENHAM PL
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2406
Practice Address - Country:US
Practice Address - Phone:224-628-9728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051298805183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist