Provider Demographics
NPI:1639481591
Name:DASGUPTA, KRANTI GOLLAPUDI (MD)
Entity Type:Individual
Prefix:DR
First Name:KRANTI
Middle Name:GOLLAPUDI
Last Name:DASGUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRANTI
Other - Middle Name:
Other - Last Name:GOLLAPUDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:825 E GOLF RD
Mailing Address - Street 2:2ND FL.
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-5700
Mailing Address - Country:US
Mailing Address - Phone:847-640-9180
Mailing Address - Fax:847-640-4450
Practice Address - Street 1:825 E GOLF RD
Practice Address - Street 2:2ND FL.
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-5700
Practice Address - Country:US
Practice Address - Phone:847-640-9180
Practice Address - Fax:847-640-4450
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.058864207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine