Gupta Medical Clinic LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036100728 Issued in IL

Legal business name

GUPTA MEDICAL CLINIC LTD

Practice address

284 Memorial CT Ste B
Crystal Lake, IL 60014-6231

Phone

(815) 459-8240

Fax

(815) 459-8470

NPI assigned

Jan 17, 2007

Last updated

Nov 12, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sanjeev Gupta, MDNPI 1659471175

Title

Owner

Phone

(815) 459-8240

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Sanjeev Gupta, MD

  • Internal Medicine Physician
  • Crystal Lake, IL
  • NPI 1659471175
  NPD (past) Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1942352547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 MEMORIAL CT STE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146231",
            "telephone_number": "815-459-8240",
            "fax_number": "815-459-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 MEMORIAL CT STE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146231",
            "telephone_number": "815-459-8240",
            "fax_number": "815-459-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUPTA MEDICAL CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "SANJEEV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-459-8240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036100728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary G Gruebnau, LSW MASTERS
• Grace Page Grzybek
• Linda Hnetynka Gullo, LCPC
• Edwin Vera Gumapas, MD
• Eshwar Gumidyala, MD
• Sanjeev Gupta, MD
• Rachel Lee Gussman
• Abigail Guthrie
• Jamie L Gutierrez
• Gwa Optical LLC

• Internal Medicine Physician in Crystal Lake, IL
• Providers in Crystal Lake, 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 Nov 12, 2009; 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.