Individual
DR. RAMONA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
676 N SAINT CLAIR ST, SUITE 800, CHICAGO, IL 60611-2927
(312) 695-3678
Mailing address
676 N SAINT CLAIR ST, SUITE 800, CHICAGO, IL 60611-2927
(312) 695-3678
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
000809
GA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
036.120641
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00809
STATE BOARD
GA
01
—
036.120641
STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
01/12/2008
Last updated
09/20/2012
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