Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036142074 | IL |
N | 111NI0900X | Internist | 036142074 | IL |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036142074 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036142074 | IL |
NPI | 1689834418 |
---|---|
Provider Name | Charu Gupta |
First Address | Vernon Hills, IL 60061-4304 |
Second Address | Vernon Hills, IL 60061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 02/04/2021 |