Provider Demographics
NPI:1316974363
Name:DAS GUPTA, NEIL A (MD)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:A
Last Name:DAS GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:120 SPALDING DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6508
Mailing Address - Country:US
Mailing Address - Phone:630-527-3788
Mailing Address - Fax:630-646-6165
Practice Address - Street 1:120 SPALDING DR
Practice Address - Street 2:SUITE 111
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6508
Practice Address - Country:US
Practice Address - Phone:630-527-3788
Practice Address - Fax:630-646-6165
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0361043292085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL92364Medicare ID - Type Unspecified
H65663Medicare UPIN