Provider Demographics
NPI:1386716165
Name:DAVE, HEMALI H (OD)
Entity type:Individual
Prefix:
First Name:HEMALI
Middle Name:H
Last Name:DAVE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:HEMALI
Other - Middle Name:H
Other - Last Name:JOSHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8901 GOLF RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-6850
Mailing Address - Country:US
Mailing Address - Phone:847-824-3127
Mailing Address - Fax:
Practice Address - Street 1:8901 GOLF RD
Practice Address - Street 2:SUITE 300
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-6850
Practice Address - Country:US
Practice Address - Phone:847-824-3127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL46009749152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILV06654Medicare UPIN