Gupta, Raj
Gupta, Raj is an individual health care provider with primary practice located at 17850 Kedzie Ave Suite 3300, Hazel Crest IL 60429-2058. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Gupta, Raj can be contacted via phone (708) 799-6055.Contact Information
Primary practice address
17850 Kedzie Ave Suite 3300
Hazel Crest IL 60429-2058
Phone: (708) 799-6055
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 036047397 | Illinois |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | 036047397 | Illinois |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036047397 | Illinois |
Profile Details
| NPI number | 1275519399 |
|---|---|
| LBN Legal business name | Gupta, Raj |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 20th, 2005 |
| Last updated | Mar 24th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275519399 | NPPES |
| Illinois | MEDICAID | 036047397 | |
| Illinois | Other | 791291236 | |
| Illinois | Other | 110103119 |
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