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General NPI Number Information
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NPI Number | 1295114932
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Entity Type | Individual
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Provider Name | AMULYA REDDY D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1830 MEDITERRANEAN DR
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City | SYCAMORE
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State | IL
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Zip | 60178-3144
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Country | US
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Telephone | 815-766-3873
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Fax | 815-766-7713
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Provider Business Mailing Address
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Address Line | 1830 MEDITERRANEAN DR
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City | SYCAMORE
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State | IL
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Zip | 60178-3144
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Country | US
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Telephone | 815-766-3873
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | OP60851254
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036171421
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License Number State | IL
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