Gupta MDSC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

GUPTA MDSC

Practice address

17850 South Kedzie Avenue
Suite 3300
Hazel Crest, IL 60429

Phone

(708) 799-6055

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Raj G Gupta, MD

Title

Owner

Phone

(708) 525-5008

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1962523720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E PEARSON ST",
            "address_2": "UNIT 2705",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606117347",
            "telephone_number": "708-525-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17850 SOUTH KEDZIE AVENUE",
            "address_2": "SUITE 3300",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "60429",
            "telephone_number": "708-799-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUPTA MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "RAJ",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-525-5008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER # FOR GUPTA MD SC",
            "identifier": "21609346",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD2646",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Guajardo Jr., MD
• Guaranteed All Services LLC
• Colleen Guinane
• Gupta Internal Medicine Associates,S.C.
• Gupta MDSC
• Sushane Gupta
• Fakher Habib, MD
• Hakeem Health Care Inc
• Martin R Hall, MD
• Roxana Hampton, LCPC

• Pulmonary Disease Physician in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Pulmonary Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.