Individual
DR. ANIL GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
421 SOUTH MAIN STREET, COLUMBIA, IL 62236
(618) 281-7151
(618) 281-6680
Mailing address
PO BOX 522, 421 SOUTH MAIN STREET, COLUMBIA, IL 62236
(618) 281-7151
(618) 281-6680
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01070862A
IN
207P00000X
Emergency Medicine Physician
036086275
IL
207P00000X
Emergency Medicine Physician
104738
MO
207Q00000X
Family Medicine Physician
01070862A
IN
207Q00000X
Family Medicine Physician
Primary
036086275
IL
207Q00000X
Family Medicine Physician
104738
MO
207RA0401X
Addiction Medicine (Internal Medicine) Physician
036086275
IL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
104738
MO
208D00000X
General Practice Physician
036086275
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036086275
—
IL
Enumeration date
04/12/2006
Last updated
04/02/2025
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