Provider Demographics
NPI:1790068872
Name:KUPFER, STUART ROY (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:ROY
Last Name:KUPFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TAKEDA PKWY
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-5713
Mailing Address - Country:US
Mailing Address - Phone:224-554-2207
Mailing Address - Fax:
Practice Address - Street 1:1 TAKEDA PKWY
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5713
Practice Address - Country:US
Practice Address - Phone:224-554-2207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-24
Last Update Date:2011-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361018212080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology