Provider Demographics
NPI:1982100012
Name:DESAI, KUNAL BANKIM (MD MBA MS)
Entity type:Individual
Prefix:DR
First Name:KUNAL
Middle Name:BANKIM
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD MBA MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5463
Mailing Address - Country:US
Mailing Address - Phone:125-603-3803
Mailing Address - Fax:
Practice Address - Street 1:1818 WEST TAYLOR STREET
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-560-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036156165207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology