Healthcare Provider Details

I. General information

NPI: 1992265672
Provider Name (Legal Business Name): NOAM KUPFER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US

IV. Provider business mailing address

800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number036174572
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: