Renu Gupta, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036-084024 Issued in IL

Practice address

1221 Longford St
Woodridge, IL 60517-7748

Phone

(630) 910-0683

Fax

(630) 910-0685

NPI assigned

Mar 9, 2007

Last updated

Feb 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Dr. Renu Garg Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/thrivecc/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand Prairie Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tinley Park, IL
  • NPI 1346304979
  Medicare reassignment NPD
• Behavioral Healthcare Providers LTD

  • Multi-Specialty Clinic/Center
  • Schaumburg, IL
  • NPI 1043781958
  Medicare reassignment
• Grand Prairie Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Park Forest, IL
  • NPI 1417132093
  NPD
• Grand Prairie Services

  • Federally Qualified Health Center (FQHC)
  • Chicago Heights, IL
  • NPI 1447723564
  NPD
• Thrive Counseling Center

  dba Family Service & Mental Health Center of Oak Park

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Park, IL
  • NPI 1467586669
  NPD
• Behavioral Health Care Associates LTD

  dba Behavioral Medicine Health Associates

  • Psychiatry Physician
  • Schaumburg, IL
  • NPI 1164932513
  NPD (past)
• Deep Buch, MD SC

  • Psychiatry Physician
  • Palos Heights, IL
  • NPI 1477212751
  NPD (past)
• Piyush C. Buch, M.D., P.C.

  • Psychiatry Physician
  • Palos Heights, IL
  • NPI 1851599823
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1609908383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 LONGFORD ST",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605177748",
            "telephone_number": "630-910-0683",
            "fax_number": "630-910-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 LONGFORD ST",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605177748",
            "telephone_number": "630-910-0683",
            "fax_number": "630-910-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "RENU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-084024",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-084024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02221309",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084024",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENU",
            "last_name": "GARG",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Grant Cardiology Services,Inc
• Nicole Lynn Green, LSW
• Kathryn Griffin, LSW
• Gary Gruendeman, D.D.S., P.C.
• Techante C Gunn
• Melissa E Gustis, MPT
• Molly Michaela Hackett
• Laura Hamad, DO
• Pat Spiropoulos Hamalis, PHD, APRN, FNP
• Camila Hamilton

• Psychiatry Physician in Woodridge, IL
• Providers in Woodridge, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.