MEDICARE: TAPAS DASGUPTA MDSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	036093907	IL
2	282N00000X	General Acute Care Hospital	036093907	IL

General Provider Information

NPI Number	:	1053330209
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAPAS DASGUPTA MDSC

Provider Business Mailing Address
First Line	:	6747 FIELDSTONE DR
Second Line	:
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-5262
Country	:	US
Telephone Number	:	312-842-7822
Fax Number	:	866-441-0698

Provider Business Practice Location Address
First Line	:	7845 S COTTAGE GROVE AVE
Second Line	:	SUITE 109
City	:	CHICAGO
State	:	IL
Zip	:	60619-3100
Country	:	US
Telephone Number	:	312-842-7822
Fax Number	:	866-441-0698

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. TAPAS DASGUPTA
Credential	:	MD
Telephone Number	:	312-224-8269

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	05/19/2011

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