Individual
SUPRIYA GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
500 W COURT ST, KANKAKEE, IL 60901
(877) 737-4636
Mailing address
1036 HICKORY DR, WESTERN SPRINGS, IL 60558-5000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036143198
IL
2085R0202X
Diagnostic Radiology Physician
4301501114
MI
2085R0202X
Diagnostic Radiology Physician
A163071
CA
2085R0202X
Diagnostic Radiology Physician
C1-0025655
DE
2085R0202X
Diagnostic Radiology Physician
MD-52771
IA
2085R0202X
Diagnostic Radiology Physician
ME140594
FL
Other
Enumeration date
06/04/2012
Last updated
08/18/2025
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