Gupta Internal Medicine Associates,S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GUPTA INTERNAL MEDICINE ASSOCIATES,S.C.

Practice address

17850 South Kedzie Avenue
Suite 3300
Hazel Crest, IL 60429

Phone

(708) 799-6055

NPI assigned

May 30, 2007

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, MD

Title

Owner

Phone

(708) 525-5008

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1326249293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E PEARSON ST",
            "address_2": "UNIT 2705",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606117347",
            "telephone_number": "708-525-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUPTA INTERNAL MEDICINE ASSOCIATES,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2017-03-24",
        "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": "708-525-5008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD2711",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER #",
            "identifier": "1619980",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaine Gottlinger, P.T.A.
• Michael Green, CADC, MISA
• Aaron Guajardo Jr., MD
• Guaranteed All Services LLC
• Colleen Guinane
• Gupta MDSC
• Gupta MDSC
• Sushane Gupta
• Fakher Habib, MD
• Hakeem Health Care Inc

• Internal Medicine Physician in Hazel Crest, IL
• Providers in Hazel Crest, 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 Mar 24, 2017; 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.