Gupta, Pavan K

Gupta, Pavan K is an individual health care provider with primary practice located at 12251 S 80Th Ave , Palos Heights IL 60463-1290. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hospitalist, which is considered as his primary health care specialty. Gupta, Pavan K can be contacted via phone (708) 923-4000.

Contact Information

Primary practice address
12251 S 80Th Ave Palos Heights IL 60463-1290
Phone: (708) 923-4000
Fax: (708) 923-5859
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 036154454 Illinois

Profile Details

NPI number 1770087231
LBN Legal business name Gupta, Pavan K
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2018
Last updated May 16th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770087231 NPPES
Illinois MEDICAID 036154454

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