Individual
SUDHA R GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-8387
(708) 202-7936
Mailing address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-8387
(708) 202-7936
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036059888
IL
Other
Enumeration date
07/03/2008
Last updated
07/03/2008
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