NPI Code Details Logo

NPI 1609969633

NPI 1609969633 : SUREKHA V REDDY MD : CHICAGO, IL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1609969633
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    SUREKHA V REDDY MD
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/02/2006
-----------------------------------------------------
    Last Update Date     |    07/08/2007
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    820 S DAMEN AVE MAIL CODE 111
-----------------------------------------------------
    City                 |    CHICAGO
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60612-3728
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    312-569-7028
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    742 SARAH LN 
-----------------------------------------------------
    City                 |    NORTHBROOK
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60062-2172
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    847-562-0899
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207R00000X
-----------------------------------------------------
    Taxonomy Name        |    Internal Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    IL
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.