MEDICARE: DR. NEIL GUPTA MD

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	207RG0100X	Gastroenterology Physician	2011001553	MO
2	207RG0100X	Gastroenterology Physician	01092779A	IN
3	207RG0100X	Gastroenterology Physician	036120055	IL

General Provider Information

NPI Number	:	1487828653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL GUPTA MD

Provider Business Mailing Address
First Line	:	1400 S MICHIGAN AVE APT 1203
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-3720
Country	:	US
Telephone Number	:	312-767-3244
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 RAND RD STE 120
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-2359
Country	:	US
Telephone Number	:	312-767-3244
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2008
Last Update Date	:	04/01/2025

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Directions to “ DR. NEIL GUPTA MD” Practice Location

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