Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036-122802 | IL |
N | 111NI0900X | Internist | 036-122802 | IL |
N | 207RH0000X | Hematologist | 036-122802 | IL |
Y | 207RX0202X | Medical Oncology | 036-122802 | IL |
NPI | 1376781252 |
---|---|
Provider Name | Shweta Gupta |
First Address | Naperville, IL 60563-2684 |
Second Address | Chicago, IL 60612-3714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2009 |
Last Update Date | 26/04/2021 |