Individual provider Active NPI

Foram Rajendra Desai, M.D.

  • Internal Medicine Physician
  • Skokie, IL
National Provider Identifier
1174722011
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036155510 Issued in IL
Practice address
9650 Gross Point Rd Ste 1900
Skokie, IL 60076-5006
Phone
(847) 676-1112
Fax
(847) 674-3358
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036155510 IL Primary

Addresses

Primary practice location

9650 Gross Point Rd Ste 1900
Skokie, IL 60076-5006

Mailing address

9650 Gross Point Rd Ste 1900
Skokie, IL 60076-5006
Phone (847) 676-1112

Other practice location 1

6326 Cermak Rd
Berwyn, IL 60402-2304
Phone (708) 303-9234

Other practice location 2

375 S. Washington Avenue
Bergenfield, NJ 07621
Phone (201) 384-0036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210603001127 IL Practitioner - Internal Medicine 8224108006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

  • Residential Home Health Home health agency, Northbrook, IL, CCN 147001
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Aug 3, 2022 Accepting new patients
PMR Illinois Holding, LLC CurrentSince Jan 1, 2022 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Aug 3, 2022 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

6326 Cermak Rd
Berwyn, IL 60402
Phone (708) 303-9234

9532 Eagle Way
Chicago, IL 60678

2734 W 87th St
Chicago, IL 60652
Phone (773) 918-4700

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

1666 Checker Rd
Long Grove, IL 60047
Phone (847) 419-1111

9650 Gross Point Rd
Ste 1900
Skokie, IL 60076
Phone (224) 251-2020

9650 Gross Point Rd
Skokie, IL 60076
Phone (224) 251-1160

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1174722011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9650 GROSS POINT RD STE 1900",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600765006",
            "telephone_number": "847-676-1112",
            "fax_number": "847-674-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 GROSS POINT RD STE 1900",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600765006",
            "telephone_number": "847-676-1112",
            "fax_number": "847-674-3358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6326 Cermak Rd",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604022304",
            "country_code": "US",
            "telephone_number": "708-303-9234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "375 S. Washington Avenue",
            "address_purpose": "LOCATION",
            "city": "Bergenfield",
            "state": "NJ",
            "postal_code": "07621",
            "country_code": "US",
            "telephone_number": "201-384-0036",
            "fax_number": "201-384-7304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESAI",
        "first_name": "FORAM",
        "middle_name": "RAJENDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036155510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.