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General NPI Number Information
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NPI Number | 1366043440
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Entity Type | Individual
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Provider Name | MOHIT GUPTA MD
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Gender | Male
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 5875 E RIVERSIDE BLVD
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City | ROCKFORD
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State | IL
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Zip | 61114-4937
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Country | US
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Telephone | 815-398-9491
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Fax | 815-381-7498
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Provider Business Mailing Address
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Address Line | PO BOX 735263
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City | CHICAGO
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State | IL
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Zip | 60673-5263
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Country | US
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Telephone | 815-398-9491
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Fax | 815-381-7498
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036165627
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125.077049
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 036165627
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License Number State | IL
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