Individual
DR. SONALI GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
180 N. STETSON, 3260 PRUDENTIAL PLAZA II,, CHICAGO, IL 60601
(773) 732-6219
Mailing address
180 N. STETSON, 3620 PRUDENTIAL PLAZA II,, CHICAGO, IL 60601
(773) 732-6219
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007789
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010108845
—
VA
01
—
188036
ANTHEM
VA
01
—
293990
AMERIGROUP
VA
01
—
715690000
MAGELLAN
VA
01
—
89130028
CAREFIRST BCBS
VA
Enumeration date
04/25/2006
Last updated
03/21/2012
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