Provider Demographics
NPI:1366451577
Name:KAKI, SUMA REDDY (MD)
Entity Type:Individual
Prefix:DR
First Name:SUMA
Middle Name:REDDY
Last Name:KAKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUMA
Other - Middle Name:REDDY
Other - Last Name:DUVVUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:899 S WEBER RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-5488
Mailing Address - Country:US
Mailing Address - Phone:630-226-1800
Mailing Address - Fax:630-226-4226
Practice Address - Street 1:899 S WEBER RD
Practice Address - Street 2:SUITE G
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-5488
Practice Address - Country:US
Practice Address - Phone:630-226-1800
Practice Address - Fax:630-226-4226
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-114593207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine