Provider Demographics
NPI:1063556991
Name:DESAI, BELA D (MD)
Entity type:Individual
Prefix:
First Name:BELA
Middle Name:D
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1935
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60017-1935
Mailing Address - Country:US
Mailing Address - Phone:847-803-1344
Mailing Address - Fax:847-803-3791
Practice Address - Street 1:77 RAND RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1005
Practice Address - Country:US
Practice Address - Phone:847-803-1344
Practice Address - Fax:847-803-3791
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100458207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036100458Medicaid
IL036100458Medicaid
H13499Medicare UPIN
740620Medicare ID - Type Unspecified