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General NPI Number Information
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NPI Number | 1891706255
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Entity Type | Individual
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Provider Name | ASHOK KUMAR GUPTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 111 N COUNTY FARM RD WEST PUBLIC HEALTH CENTER
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City | WHEATON
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State | IL
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Zip | 60187-3977
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Country | US
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Telephone | 630-682-7560
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Fax | 630-462-7945
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Provider Business Mailing Address
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Address Line | 3135 BENNETT PL
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City | AURORA
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State | IL
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Zip | 60502-7069
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Country | US
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Telephone | 630-499-8661
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | IL
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