Gupta, Sanjeev

Gupta, Sanjeev is an individual health care provider with primary practice located at 525 E Congress Pkwy Ste 350 , Crystal Lake IL 60014-6271. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Gupta, Sanjeev can be contacted via phone (815) 479-7490.

Contact Information

Primary practice address
525 E Congress Pkwy Ste 350 Crystal Lake IL 60014-6271
Phone: (815) 479-7490
Fax: (815) 455-2654
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036100728 Illinois

Profile Details

NPI number 1659471175
LBN Legal business name Gupta, Sanjeev
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 24th, 2006
Last updated Dec 20th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659471175 NPPES
Illinois Other 110217799 MEDICARE RAILROAD
Illinois Other 0364380077 MEDICARE RAILROAD
Illinois MEDICAID 036100728 MEDICARE RAILROAD
Illinois Other 05623656 MEDICARE RAILROAD

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