Individual
ANAND KUMAR GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20201 CRAWFORD AVE, OLYMPIA FIELDS, IL 60461-1010
(708) 679-2160
(708) 679-2161
Mailing address
1040 SIERRA DR STE 400, GREENWOOD, IN 46143-7241
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.124114
IL
208M00000X
Hospitalist Physician
Primary
036124114
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036124114
—
IL
01
—
IL5686059
MEDICARE PTAN
IL
Enumeration date
06/03/2010
Last updated
03/22/2021
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