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General NPI Number Information
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NPI Number | 1821160136
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Entity Type | Individual
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Provider Name | ATUL N GUPTA MD
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 1051 ESSINGTON RD SUITE 210
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City | JOLIET
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State | IL
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Zip | 60435-2801
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Country | US
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Telephone | 815-726-1818
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Fax | 815-726-0232
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Provider Business Mailing Address
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Address Line | 1051 ESSINGTON RD SUITE 210
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City | JOLIET
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State | IL
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Zip | 60435-2801
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Country | US
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Telephone | 815-726-1818
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Fax | 815-726-0232
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 036105920
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License Number State | IL
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