Provider Demographics
NPI:1275636482
Name:DASGUPTA, TAPAS K (MD, PHD, DSC)
Entity Type:Individual
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First Name:TAPAS
Middle Name:K
Last Name:DASGUPTA
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Gender:M
Credentials:MD, PHD, DSC
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Other - Middle Name:
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Mailing Address - Street 1:840 S WOOD ST
Mailing Address - Street 2:618 CSB, MC 820
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4325
Mailing Address - Country:US
Mailing Address - Phone:312-996-6134
Mailing Address - Fax:312-996-9365
Practice Address - Street 1:1740 W TAYLOR ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7232
Practice Address - Country:US
Practice Address - Phone:866-600-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0360422942086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D12196Medicare UPIN