Healthcare Provider Details

I. General information

NPI: 1487669156
Provider Name (Legal Business Name): SATISH REDDY DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 W MONTROSE AVE
CHICAGO IL
60618-1312
US

IV. Provider business mailing address

3020 W MONTROSE AVE
CHICAGO IL
60618-1312
US

V. Phone/Fax

Practice location:
  • Phone: 773-754-3900
  • Fax: 773-754-3905
Mailing address:
  • Phone: 773-754-3900
  • Fax: 773-754-3907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. SATISH REDDY
Title or Position: DENTIST
Credential:
Phone: 773-754-3900