Healthcare Provider Details
I. General information
NPI: 1831518539
Provider Name (Legal Business Name): ANITA GUPTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/09/2014
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US
IV. Provider business mailing address
2650 RIDGE AVE # 1223
EVANSTON IL
60201-1700
US
V. Phone/Fax
- Phone: 847-570-2530
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | 036127295 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282NC2000X |
| Taxonomy | Children's Hospital |
| License Number | 036127295 |
| License Number State | IL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 036127295 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: