Individual provider Active NPI

Dina Desai, M.D.

  • Family Medicine Physician
  • Willowbrook, IL
National Provider Identifier
1487678454
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036085129 Issued in IL
Practice address
7050 S Madison St
Willowbrook, IL 60527-5548
Phone
(630) 889-8922
Fax
(630) 424-0021
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036085129 IL Primary

Addresses

Primary practice location

7050 S Madison St
Willowbrook, IL 60527-5548

Mailing address

7050 Madison Street
Willowbrook, IL 60527-5548
Phone (630) 889-8922

Other identifiers 1

IdentifierTypeStateIssuer
036085129MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036085129ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakbrook Primary Care Family Medicine PastSince Jan 1, 1990 Accepting new patients
Fall Prevention Services, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1487678454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 MADISON STREET",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275548",
            "telephone_number": "630-889-8922",
            "fax_number": "630-424-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 S MADISON ST",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275548",
            "telephone_number": "630-889-8922",
            "fax_number": "630-424-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "DINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036085129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085129",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.