Provider Demographics
NPI:1588847461
Name:ARATI A REDDY MD SC
Entity Type:Organization
Organization Name:ARATI A REDDY MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ARATI
Authorized Official - Middle Name:A
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-945-9227
Mailing Address - Street 1:441 ROUTE 130
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2340
Mailing Address - Country:US
Mailing Address - Phone:774-338-5120
Mailing Address - Fax:774-338-5378
Practice Address - Street 1:720 S BROM DR
Practice Address - Street 2:SUITE 204
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6534
Practice Address - Country:US
Practice Address - Phone:630-848-1332
Practice Address - Fax:630-848-1344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042619133207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1306803028Medicare UPIN
ILI20296Medicare UPIN