Organization
GUPTA MEDICAL CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJEEV GUPTA MD (OWNER)
(815) 459-8240
Entity
Organization
Contact information
Practice address
284 MEMORIAL CT STE B, CRYSTAL LAKE, IL 60014-6231
(815) 459-8240
(815) 459-8470
Mailing address
284 MEMORIAL CT STE B, CRYSTAL LAKE, IL 60014-6231
(815) 459-8240
(815) 459-8470
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036100728
IL
Other
Enumeration date
01/17/2007
Last updated
11/12/2009
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