Individual
DR. BALAJI GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 S HIGHLAND AVE, SUITE 110, LOMBARD, IL 60148-5363
(630) 495-2220
Mailing address
2500 S HIGHLAND AVE, SUITE 110, LOMBARD, IL 60148-5363
(630) 495-2220
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
36-081843
IL
Other
Enumeration date
04/05/2006
Last updated
05/12/2010
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