Individual
DR. ATUL N GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1051 ESSINGTON RD, SUITE 210, JOLIET, IL 60435-2801
(815) 726-1818
(815) 726-0232
Mailing address
1051 ESSINGTON RD, SUITE 210, JOLIET, IL 60435-2801
(815) 726-1818
(815) 726-0232
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036105920
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105920
—
IL
01
—
09900582
BLUE CROSS BLUE SHIELD
IL
01
—
P00245235
MEDICARE RAILROAD
IL
Enumeration date
11/14/2006
Last updated
09/26/2019
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