Healthcare Provider Details

I. General information

NPI: 1114453446
Provider Name (Legal Business Name): PRERANA REDDY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S WASHINGTON ST
NAPERVILLE IL
60540-7430
US

IV. Provider business mailing address

2650 RIDGE AVE
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 630-527-5197
  • Fax: 630-527-5526
Mailing address:
  • Phone: 732-429-0838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036152174
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036152174
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: