DR. RAJ GUPTA (NPI# 1275519399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275519399 |
| Entity Type | Individual |
| Full Name | DR. RAJ GUPTA |
| Credential | MD |
| Practice Address |
17850 Kedzie Ave Suite 3300 Hazel Crest IL 60429-2058 |
| Mailing Address |
222 E Pearson St Unit 2705 Chicago IL 60611-7347 |
| Practice Telephone | 7087996055 |
| Mailing Telephone | 7085255008 |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2017-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036047397 | IL | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
036047397 | IL | Allopathic & Osteopathic Physicians |
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
036047397 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036047397 | 05 | |
| RAILROAD MEDICARE PROVIDER # | 791291236 | 01 | |
| RAILROAD MEDICARE PROVIDER # | 110103119 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386707966 | Raj Andrew Gupta | Chiropractor | 1806 State Route 35, Oakhurst, NJ 07755-2700 | 2006-12-18 |
| 1124103403 | Raj K Gupta | Pediatrics | 31 N Locust St, West Carrollton, OH 45449-1407 | 2006-10-26 |
| 1497783286 | Raj Kumar Gupta | Plastic Surgery | 10501 North Telegraph Road, Suite 104, Taylor, MI 48180-3376 | 2006-06-29 |
| 1891883245 | Raj R Gupta | Radiology | 1826 Veterans Blvd, Macon, GA 31021 | 2006-10-11 |
| 1861593139 | Raj K Gupta | Internal Medicine | 21 Clark Pl, Old Stone Bldg, Mahopac, NY 10541 | 2006-09-26 |
| 1831126689 | Raj Gupta | Psychiatry & Neurology | 200 Jose Figueres Ave, Ste 200, San Jose, CA 95116-1586 | 2006-06-27 |
| 1346215605 | Raj Rani Gupta | Internal Medicine | 228 Billerica Rd, Internal Medicine, Chelmsford, MA 01824-3604 | 2006-02-21 |
| 1548248289 | Raj R Gupta | Internal Medicine | 308 Coliseum Dr Ste 120, Macon, GA 31217-3859 | 2006-01-04 |
| Street Address |
17850 KEDZIE AVE SUITE 3300 |
| City | HAZEL CREST |
| State | IL |
| Zip Code | 60429-2058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912903691 | Robert Heidenry | Ophthalmology | 17850 Kedzie Ave, Suite 3500, Hazel Crest, IL 60429-2058 | 2005-06-27 |
| 1528517059 | Lynn Roxas Kelly | Nurse Practitioner | 17850 Kedzie Ave, Hazel Crest, IL 60429-2058 | 2016-09-26 |
| 1356744452 | Kristi Hughes | Nurse Practitioner | 17850 Kedzie Ave, Hazel Crest, IL 60429-2058 | 2014-10-02 |
| 1861810574 | Cindy M Spicka | Registered Nurse | 17850 Kedzie Ave, Suite #3250, Hazel Crest, IL 60429-2058 | 2014-03-31 |
| 1497004139 | Medplus Medical Center Sc | Family Medicine | 17850 Kedzie Ave, Suite 2200, Hazel Crest, IL 60429-2058 | 2012-09-07 |
| 1104054386 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 17850 Kedzie Ave, Suite 3200, Hazel Crest, IL 60429-2058 | 2009-06-26 |
| 1255596318 | Subba Rao Md Sc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 17850 Kedzie Ave, Suite 3000, Hazel Crest, IL 60429-2058 | 2008-07-28 |
| 1013177278 | Varsha Bhan Md Sc | Clinic/Center | 17850 Kedzie Ave, Suite 1700, Hazel Crest, IL 60429-2058 | 2008-06-11 |
| 1346434651 | Womens Wellness World Sc | Obstetrics & Gynecology | 17850 Kedzie Ave, #2600, Hazel Crest, IL 60429-2058 | 2007-08-29 |
| 1104948967 | Christopher T. Kardasis M.d., S.c. | Ophthalmology | 17850 Kedzie Ave, Doctors Pavilion Suite 1200, Hazel Crest, IL 60429-2058 | 2007-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659917987 | Nancy Sinwelski | Technician | 17305 Fisk Street, East Hazelcrest, IL 60429 | 2019-11-21 |
| 1144720871 | Plentiful Hair Studio LLC | Specialist | 17504 E Carriageway Dr Ste D, Hazel Crest, IL 60429 | 2018-02-19 |
| 1376052142 | Natalie Allen | Counselor | 3518 Birchwood Dr, Hazel Crest, IL 60429 | 2017-09-25 |
| 1730534009 | Lydena Franklin | Counselor | 1909 Cheker Square, East Hazel Crest, IL 60429 | 2016-04-25 |
| 1710331053 | Lauiren Orta | Counselor | 1901 Cheker Square, E Hazel Crest, IL 60429 | 2016-04-22 |
| 1427423367 | Andrea Leigh Warren | Nurse Practitioner | 17800 S. Kedzie Ave, Hazel Crest, IL 60429 | 2015-12-03 |
| 1770969354 | Karriem's Developmental Services | Day Training, Developmentally Disabled Services | 18513 River Road, Hazel Crest, IL 60429 | 2015-08-05 |
| 1073905170 | James Kamper | Physical Therapy Assistant | 1816 W 170th Street, Hazel Crest, IL 60429 | 2015-02-26 |
| 1194066019 | Marilyn C Scott | Psychologist | 18505 Meadow Ln., Hazel Crest, IL 60429 | 2013-03-04 |
| 1649548405 | Supported Independence | Community/Behavioral Health | 17009 Elm Drive, Hazel Crest, IL 60429 | 2011-12-08 |
| Find all providers in zip 60429 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518123363 | Christen Tibbs | Internal Medicine | 3330 W 177th St Ste 2d-1, Hazel Crest, IL 60429-2184 | 2008-07-31 |
| 1992881445 | William I Crevier Md Ltd | Internal Medicine | 3330 W 177th St Ste 3e, Hazel Crest, IL 60429-2186 | 2006-10-27 |
| 1780673897 | Nader M Beshay | Internal Medicine | 3330 W 177th St, Suite 3 H, Hazel Crest, IL 60429-2001 | 2005-10-20 |
| 1164954707 | Mariam Tariq Mir | Internal Medicine | 17800 Kedzie Ave, Hazel Crest, IL 60429-2029 | 2017-04-02 |
| 1477818961 | Primary Care for You Ltd. | Internal Medicine | 3330 W 177th St, Suite 3h, Hazel Crest, IL 60429-2184 | 2012-07-10 |
| 1093028359 | Gladys Macagba | Internal Medicine | 17800 Kedzie Ave, Hazel Crest, IL 60429-2029 | 2010-07-15 |
| 1356530547 | Sfz Corporation | Internal Medicine | 3330 W 177th St, Suite 3d, Hazel Crest, IL 60429-2184 | 2007-10-24 |
| 1326249293 | Gupta Internal Medicine Associates,s.c. | Internal Medicine | 17850 South Kedzie Avenue, Suite 3300, Hazel Crest, IL 60429 | 2007-05-30 |
| 1609905348 | Philippa Norman | Internal Medicine | 17850 Kedzie Ave, Ste 1100, Hazel Crest, IL 60429-2055 | 2007-03-05 |
| 1376694299 | Nader Beshay, Md Sc | Internal Medicine | 3330 W 177th St, Suite 3 H, Hazel Crest, IL 60429-2184 | 2007-01-16 |
| Find all providers in HAZEL CREST | ||||
| City | HAZEL CREST |
| Zip Code | 60429 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.