Individual
PURNENDU GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2211 NORTH OAK PARK AVENUE, SUITE 3A, CHICAGO, IL 60707-3329
(773) 385-5497
(773) 385-5488
Mailing address
2211 NORTH OAK PARK AVENUE, CHICAGO, IL 60707-3329
(773) 385-5497
(773) 385-5488
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
36086266
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036086266
—
IL
Enumeration date
12/01/2006
Last updated
02/11/2021
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