NPIMap

Individual provider Active NPI

Sanjeev Gupta, MD

  • Internal Medicine Physician
  • Crystal Lake, IL
National Provider Identifier
1659471175
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036100728 Issued in IL
Practice address
525 E Congress Pkwy Ste 350
Crystal Lake, IL 60014-6271
Phone
(815) 479-7490
Fax
(815) 455-2654
NPI assigned
Sep 24, 2006
Last updated
May 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036100728 IL Primary

Addresses

Primary practice location

525 E Congress Pkwy Ste 350
Crystal Lake, IL 60014-6271

Mailing address

29373 Network PL
Chicago, IL 60673-1293

Other identifiers 4

IdentifierTypeStateIssuer
036100728MedicaidIL
0364380077OtherILCOMMERCIAL
110217799OtherILMEDICARE RAILROAD
05623656OtherILBCBS

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sgupta206226@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041007000063 IL Practitioner - Internal Medicine 4183683030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 344-5000

450 W Hwy 22
Neonatology
Barrington, IL 60010-1919
Phone (847) 381-0123

486 Randall Rd
Unit B
South Elgin, IL 60177-3354
Phone (224) 783-5000

525 E Congress Pkwy
Crystal Lake, IL 60014-6258

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036100728ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jul 2, 2012 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 2, 2012 Accepting new patients
Gupta Medical Clinic LTD Internal Medicine PastSince Sep 1, 1999 Accepting new patients

Locations

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

284 Memorial Ct
Ste B
Crystal Lake, IL 60014
Phone (815) 459-8240

525 E Congress Pkwy
Ste 350
Crystal Lake, IL 60014
Phone (815) 455-7400

Interoperability endpoints

  • Direct secure messaging: sgupta206226@direct.myadvocateaurora.org

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1659471175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E CONGRESS PKWY STE 350",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146271",
            "telephone_number": "815-479-7490",
            "fax_number": "815-455-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SANJEEV",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036100728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100728",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "0364380077",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110217799",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05623656",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgupta206226@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "525 E Congress Pkwy Ste 350",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600146271",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "525 E Congress Pkwy Ste 350",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600146271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.