Gautam Gupta

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GAUTAM GUPTA

Practice address

6090 Strathmoor Dr
Suite #4
Rockford, IL 61107-6628

Phone

(815) 229-1899

Fax

(815) 231-1218

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Gautam Gupta, M.D.NPI 1477734226

Title

Sole Proprietor

Phone

(815) 229-1899

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gautam Gupta, M.D.

  • Internal Medicine Physician
  • Rockford, IL
  • NPI 1477734226
  NPD (past) Authorized official

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1023177128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6090 STRATHMOOR DR",
            "address_2": "SUITE #4",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076628",
            "telephone_number": "815-229-1899",
            "fax_number": "815-231-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6090 STRATHMOOR DR",
            "address_2": "SUITE #4",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076628",
            "telephone_number": "815-229-1899",
            "fax_number": "815-231-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUTAM GUPTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "GAUTAM",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "815-229-1899",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0010100611",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Constance Miller Garry, LCPC
• Joseph Patrick Garry, MD
• Jacob Gartner, DPT
• Sylvia Ann Garza, APN-BC
• Takyia Gaston-Peyton, RBT
• Gautam Gupta MD LLC
• Delsie Bella Gavali, MD
• Emily Gawaran, NP
• Joseph A Gaziano, PA-C
• Michael L Gaziano, MSW LCSW

• Internal Medicine Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.