Provider Demographics
NPI:1053330209
Name:TAPAS DASGUPTA MDSC
Entity Type:Organization
Organization Name:TAPAS DASGUPTA MDSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TAPAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DASGUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-224-8269
Mailing Address - Street 1:6747 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5262
Mailing Address - Country:US
Mailing Address - Phone:312-842-7822
Mailing Address - Fax:866-441-0698
Practice Address - Street 1:7845 S COTTAGE GROVE AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-3100
Practice Address - Country:US
Practice Address - Phone:312-842-7822
Practice Address - Fax:866-441-0698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093907282N00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG45668Medicare UPIN