Provider Demographics
NPI:1518002245
Name:POPLI, GOPAL K (MD)
Entity Type:Individual
Prefix:DR
First Name:GOPAL
Middle Name:K
Last Name:POPLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:121 SAINT FRANCIS CIR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2560
Mailing Address - Country:US
Mailing Address - Phone:630-493-4370
Mailing Address - Fax:630-493-4371
Practice Address - Street 1:4901 W 79TH ST
Practice Address - Street 2:SUITE#1
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-1554
Practice Address - Country:US
Practice Address - Phone:630-827-0100
Practice Address - Fax:630-827-0103
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036054407207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036054407Medicaid
IL036054407/01Medicaid
IL995270OtherMEDICARE GROUP
IL21608842OtherBCBS IL
IL21608842OtherBCBS IL
ILD14953Medicare UPIN