Individual provider Active NPI

Rajat Gupta, M.D.

  • Anesthesiology Physician
  • Waukegan, IL
National Provider Identifier
1790725240
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036101774 Issued in IL
Practice address
1324 N Sheridan Rd
Waukegan, IL 60085-2161
Phone
(847) 360-3000
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036101774 IL Primary
Interventional Pain Medicine Physician 208VP0014X 036101774 IL

Addresses

Primary practice location

1324 N Sheridan Rd
Waukegan, IL 60085-2161

Mailing address

PO Box 70
Lake Forest, IL 60045-0070

Other identifiers 1

IdentifierTypeStateIssuer
036101774MedicaidIL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080325000482 IL Practitioner - Anesthesiology 3779669114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Anesthesia Partners LLCGroup PAC ID 6204737596, 117 clinicians

Practice addresses (Care Compare)

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 362-2900

Hospital & facility affiliations

  • St Alexius Medical Center Hospital, Hoffman Estates, IL, CCN 140290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036101774ILMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Partners, LLC Anesthesiology CurrentSince Sep 1, 2014 Accepting new patients
Chicago Area Partners in Anesthesia LLC Anesthesiology Past Accepting new patients

Locations

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

185 Penny Ave
East Dundee, IL 60118
Phone (847) 836-7015

801 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-2900

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

1324 N Sheridan Rd
Waukegan, IL 60085
Phone (847) 360-3000

Organizations & group practices 2

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

Hospital & facility affiliations 1

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1790725240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600450070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "RAJAT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036101774",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036101774",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101774",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.