DR. MANISH GUPTA


Address: 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168
Phone: 3096768123

DR. MANISH GUPTA (NPI# 1558399238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1558399238
Entity Type Individual
Full Name DR. MANISH GUPTA
Credential MD
Practice Address 420 Ne Glen Oak Ave Ste 401
Peoria
IL 61603-3168
Mailing Address 420 Ne Glen Oak Ave
Ste 401
Peoria
IL 61603-3168
Practice Telephone 3096768123
Practice Fax Number 3096768455
Mailing Telephone 3096768123
Mailing Fax Number 3096248339
Enumeration Date 2006-06-29
Last Update Date 2018-10-29
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208600000X Surgery 036138105 IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL 036138105 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
430 Maxine Dr, Morton, IL 615502495 3092667600 3092667680

Other Providers MANISH GUPTA

NPI Name Taxonomy Address Enumeration
1609356625 Manish Gupta Technician, Other 4418 Bluebonnet Dr Ste 401, Stafford, TX 77477-2904 2018-08-20
1073001772 Manish Kumar Gupta Student in an Organized Health Care Education/Training Program Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810 2018-04-27
1528250966 Manish P Gupta Internal Medicine 66 Hawkridge Drive, Las Vegas, NV 89135 2007-08-09
1891007936 Manish Gupta Dentist 11201 Shaker Blvd Ste 136, Cleveland, OH 44104-3833 2010-07-06
1770687386 Manish K Gupta Orthopaedic Surgery 9325 Glades Rd, Suite 205, Boca Raton, FL 33434-3988 2006-09-12
1144262023 Manish Gupta Internal Medicine 777 Walter Reed Blvd, Suite 201, Garland, TX 75042-5727 2006-06-12
1124005863 Manish R Gupta Surgery 1050 Isaac Streets Dr, Suite 136, Oregon, OH 43616-3291 2005-12-23

Office Location

Street Address 420 NE GLEN OAK AVE STE 401
City PEORIA
State IL
Zip Code 61603-3168

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710974597 Timothy P Oconnor Transplant Surgery 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603 2005-10-05
1962994707 Michelle Sue Dehne Nurse Practitioner 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 2018-06-06
1780060517 Danae Smith Nurse Practitioner 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 2015-08-04
1568848497 Sarah Adams Nurse Practitioner 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 2015-08-03
1225434772 Tonya Moore Registered Nurse 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 2014-11-11
1497172399 Jill Oberle Nurse Practitioner 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 2014-03-28
1629344064 David Edward Houser Internal Medicine 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 2012-03-29
1538325477 Raji Jacob Internal Medicine 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 2008-07-30
1669648309 Muhammad Waqar Khattak Internal Medicine 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603 2008-05-02
1982816237 Anu Vishwanath Pediatrics 420 Ne Glen Oak Ave Ste 401, Suite 401, Peoria, IL 61603-3168 2007-05-07
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598362980 Courtney Klein Nurse Practitioner 1306 N. Berkley Ave, Peoria, IL 61603 2020-10-08
1114588217 Kong Xing Wang Dentist 320 East Armstrong Ave, Peoria, IL 61603 2019-06-28
1073015319 Sara Kristine Rosenbery Nurse Practitioner 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 2018-03-02
1861860058 Jennifer Michelle Kelsey Clinical Nurse Specialist 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 2015-09-04
1467859793 Bonnie Lansing Counselor 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 2014-12-02
1639597172 Jael K. Mahasi Counselor 1800 Ne Perry Avenue, Peoria, IL 61603 2014-04-02
1992054829 Justin S Ferragut Radiology 530 Northeast Glen Oak Avenue, Peoria, IL 61603 2012-09-06
1780952994 Syed Muhammad Tayyab Internal Medicine 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 2011-12-02
1528389079 St. Francis Medical Center General Acute Care Hospital 530 N E Glen Oak Ave, Peoria, IL 61603 2010-06-18
1780810648 Children's Home Association of Illinois Voluntary or Charitable 400 E. Frye, Peoria, IL 61603 2009-06-05
Find all providers in zip 61603

Taxonomy Information

Taxonomy Code 208600000X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery

Taxonomy Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1235760406 Star Surgery Center, LLC Surgery 14155 N 83rd Ave Ste 140, Peoria, AZ 85381-5652 2020-01-28
1093008237 Jordan J Glenn Surgery 6750 W Thunderbird Rd Ste B-108, Peoria, AZ 85381-5026 2011-05-20
1023207131 Comprehensive Breast Center of Arizona Plc Surgery 9179 W Thunderbird Rd # 103, Peoria, AZ 85381-4875 2007-10-15
1659589653 Matthew Lawrence Lynch Surgery 26900 N Lake Pleasant Pkwy, Peoria, AZ 85383-1558 2007-05-21
1457480063 Lorin Dixon Whittaker Jr. Surgery 624 Ne Glen Oak Ave, 2686, Peoria, IL 61603-3135 2007-03-02
1639132087 Brian Edward Prebil Surgery 14155 N. 83rd Ave., Ste. A-105, Peoria, AZ 85381 2006-04-07
1073584470 Eric L Thomas Surgery 14155 N 83rd Ave Ste A105, Peoria, AZ 85381-5640 2006-02-01
1801874565 Maqbool B Ali Surgery 4930 N Executive Dr, Peoria, IL 61614-4894 2006-01-04
1518956465 Leann Cari Allgood Surgery 9159 W Thunderbird Rd, Peoria, AZ 85381-4910 2005-10-13
1225037310 John J Brothwell Surgery 9856 W Villa Lindo Dr, Peoria, AZ 85383-1339 2005-07-20
Find all providers in PEORIA

Competitor

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City PEORIA
Zip Code 61603

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Dataset Information

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.

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