Sudha R Gupta, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

036059888 Issued in IL

Practice address

5000 S 5TH Ave
Hines, IL 60141-3030

Phone

(708) 202-8387

Fax

(708) 202-7936

NPI assigned

Jul 3, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1093978694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "708-202-8387",
            "fax_number": "708-202-7936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "708-202-8387",
            "fax_number": "708-202-7936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SUDHA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036059888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imelda Guerra, LCSW
• Lisa Ashley Guerra, AU.D.
• Antoinette Guirguis
• Patricia Ann Gully, RN,CACP
• William Peter Gunnar, M.D.
• Thomas A Gustafson, RPH
• Salvador Gutierrez, MD
• Edwin Guzman, MS, CRC, LCPC
• Krista Hagert, RD
• Bernadine C Hamburg

• Neurology Physician in Hines, IL
• Providers in Hines, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.