NPIMap

Organization Active NPI

Gautam Gupta MD LLC

  • Internal Medicine Physician
  • Rockford, IL
National Provider Identifier
1396063046
Registry record updated May 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GAUTAM GUPTA MD LLC
Practice address
6090 Strathmoor Dr
Rockford, IL 61107-6628
Phone
(815) 229-1899
NPI assigned
May 5, 2010
Last updated
May 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2010

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

Authorized official

Name
Gautam Gupta, MDNPI 1477734226
Title
Owner
Phone
(815) 229-1899

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

6090 Strathmoor Dr
Rockford, IL 61107-6628

Mailing address

4525 Forest View Ave
Rockford, IL 61108-6406
Phone (815) 965-8505

National Provider Directory

National Provider Directory

Locations

2355 S Arlington Heights Rd
Ste 150
Arlington Heights, IL 60005
Phone (847) 806-8400

1560 Wall St
Ste 128
Naperville, IL 60563
Phone (630) 219-2002

6090 Strathmoor Dr
Ste 4
Rockford, IL 61107
Phone (815) 229-1899

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273017600000",
    "number": "1396063046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 FOREST VIEW AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611086406",
            "telephone_number": "815-965-8505",
            "fax_number": "815-965-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6090 STRATHMOOR DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076628",
            "telephone_number": "815-229-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUTAM GUPTA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-05",
        "last_updated": "2010-05-05",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "GAUTAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-229-1899",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.