Provider Demographics
NPI:1225297823
Name:GUPTA, SHEILA (MS,MS,OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MS,MS,OTR/L
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:P
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,MS,OTR/L
Mailing Address - Street 1:600 OAKMONT LANE
Mailing Address - Street 2:600C
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:630-928-5080
Practice Address - Street 1:136 BIESTERFIELD ROAD
Practice Address - Street 2:
Practice Address - City:ELKGROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007
Practice Address - Country:US
Practice Address - Phone:847-956-5910
Practice Address - Fax:847-956-5420
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056002365225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist