Individual provider Active NPI

Vijay Desai, M.D.

  • Emergency Medicine Physician
  • Watseka, IL
National Provider Identifier
1497748040
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Practice address
200 E Fairman Ave
Watseka, IL 60970-1644
Phone
(630) 321-8300
Fax
(630) 321-8750
NPI assigned
Aug 30, 2005
Last updated
Jul 16, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X IL Primary

Addresses

Primary practice location

200 E Fairman Ave
Watseka, IL 60970-1644

Mailing address

150 Quail Ridge Dr
Westmont, IL 60559-6142
Phone (630) 321-8300

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
I20040319000245 IL Practitioner - Emergency Medicine 0244120475 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-064134ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Jan 4, 2016 Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Jan 4, 2016 Accepting new patients
Health Service Systems, Inc CurrentSince Jan 1, 2016 Accepting new patients
Health Service Systems, Inc CurrentSince Jan 1, 2016 Accepting new patients
Greater Elgin Emergency Specialists LTD Emergency Medicine Past Accepting new patients
Unimed, LTD Past Accepting new patients
Hoopeston Emergency Medicine Specialists, LTD. Emergency Medicine Past Accepting new patients
St. Anthony Home Medical Equipment Past Accepting new patients
Emergency Care Physician Services-Blue Island LTD Emergency Medicine Past Accepting new patients
Emergency Care Physician Services Emergency Medicine Past Accepting new patients
Illinois/Indiana Em-I Medical Services, S.C. Emergency Medicine Past Accepting new patients
Fischer Mangold/Joliet Emergency Medicine Past Accepting new patients
Heartland Emergency Specialists, LLC Emergency Medicine Past Accepting new patients
Empact Emergency Physicians LLC Past Accepting new patients

Locations

1200 Maple Rd
Joliet, IL 60432
Phone (815) 740-1100

12701 W 143rd St
Lockport, IL 60491
Phone (708) 364-6337

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850

925 West St
Peru, IL 61354
Phone (815) 223-3300

111 Spring St
Streator, IL 61364
Phone (815) 672-4587

Organizations & group practices 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1497748040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 QUAIL RIDGE DR",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605596142",
            "telephone_number": "630-321-8300",
            "fax_number": "630-321-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E FAIRMAN AVE",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701644",
            "telephone_number": "630-321-8300",
            "fax_number": "630-321-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "VIJAY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watseka, IL

Sources for this page

Verify at the official NPI Registry.