Individual
SURAJ AMAR GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 723-5020
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
000000000
IL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
036-139687
IL
208600000X
Surgery Physician
125.061269
IL
Other
Enumeration date
07/10/2012
Last updated
04/09/2026
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