Gupta, Renu

Gupta, Renu is an sole proprietor health care provider with primary practice located at 1221 Longford St , Woodridge IL 60517-7748. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Gupta, Renu can be contacted via phone (630) 910-0683.

Contact Information

Primary practice address
1221 Longford St Woodridge IL 60517-7748
Phone: (630) 910-0683
Fax: (630) 910-0685
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-084024 Illinois
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 036-084024 Illinois

Profile Details

NPI number 1609908383
LBN Legal business name Gupta, Renu
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 9th, 2007
Last updated Feb 25th, 2020 - about 6 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 1609908383 NPPES
Illinois Other 02221309 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 036084024 BLUE CROSS BLUE SHIELD

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