=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588847461
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARATI A REDDY MD SC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2007
-----------------------------------------------------
Last Update Date | 05/01/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 720 S BROM DR SUITE 204
-----------------------------------------------------
City | NAPERVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60540-6534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-848-1332
-----------------------------------------------------
Fax | 630-848-1344
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 441 ROUTE 130
-----------------------------------------------------
City | SANDWICH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02563-2340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-338-5120
-----------------------------------------------------
Fax | 774-338-5378
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHAIRMAN
-----------------------------------------------------
Name | DR. ARATI A REDDY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 708-945-9227
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number | 042619133
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------