Gupta MDSC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

036062946 Issued in IL

Legal business name

GUPTA MDSC

Practice address

17850 Kedzie Ave Ste 3300
Hazel Crest, IL 60429-2086

Phone

(708) 799-8440

NPI assigned

May 31, 2007

Last updated

Oct 31, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Raj G Gupta

Title

Owner

Phone

(708) 799-6055

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1144421595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17850 SOUTH KEDZIE AVENUE",
            "address_2": "SUITE 3300",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "60429",
            "telephone_number": "708-799-6055",
            "fax_number": "708-799-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17850 KEDZIE AVE STE 3300",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292086",
            "telephone_number": "708-799-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUPTA MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "RAJ",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-799-6055",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036062946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110060487",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "21609346",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062946",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Green, CADC, MISA
• Aaron Guajardo Jr., MD
• Guaranteed All Services LLC
• Colleen Guinane
• Gupta Internal Medicine Associates,S.C.
• Gupta MDSC
• Sushane Gupta
• Fakher Habib, MD
• Hakeem Health Care Inc
• Martin R Hall, MD

• Pulmonary Disease Physician in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Pulmonary Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; 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.