Provider Demographics
NPI:1316002538
Name:RUPANI, GITA (MD)
Entity Type:Individual
Prefix:MS
First Name:GITA
Middle Name:
Last Name:RUPANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 SOUTH PRAIRIE AVE
Mailing Address - Street 2:#1306
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605
Mailing Address - Country:US
Mailing Address - Phone:312-880-0087
Mailing Address - Fax:773-834-2218
Practice Address - Street 1:1515 SOUTH PRAIRIE AVE
Practice Address - Street 2:#1306
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-3043
Practice Address - Country:US
Practice Address - Phone:312-880-0087
Practice Address - Fax:773-834-2218
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036063645207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4970778008Medicaid
IL4970778008Medicaid
ILP02130Medicare PIN