Individual
IRMA KUPTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6400 W COLLEGE DR STE 600, PALOS HEIGHTS, IL 60463-1900
(708) 425-4662
(708) 425-4692
Mailing address
221 PINE TREE LN, LA GRANGE PARK, IL 60526-1115
(847) 653-8413
(847) 292-0850
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-091117
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10584976
CAQH
IL
Enumeration date
06/12/2006
Last updated
07/30/2022
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