Individual
ANITA GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
225 EAST CHICAGO AVENUE BOX -152, CHICAGO, IL 60611-2605
(312) 227-7408
Mailing address
2342 HIGHMOOR RD, HIGHLAND PARK, IL 60035-1704
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
036127295
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036127295
—
IL
Enumeration date
04/09/2014
Last updated
04/09/2014
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