Individual
GOPAL N. GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, FAHEY CENTER, BLDG 54, MAYWOOD, IL 60153-3328
(708) 216-5098
(708) 126-1699
Mailing address
2160 S 1ST AVE, FAHEY CENTER, BLDG 54, MAYWOOD, IL 60153-3328
(708) 216-5098
(708) 126-1699
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036128866
IL
Other
Enumeration date
02/16/2007
Last updated
04/09/2021
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