Provider Demographics
NPI:1639551740
Name:REDDY, MYTHRI MEGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MYTHRI
Middle Name:MEGAN
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2650 RIDGE AVE.
Mailing Address - Street 2:DEPT. OF RADIOLOGY
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1057
Mailing Address - Country:US
Mailing Address - Phone:847-570-2477
Mailing Address - Fax:847-570-2942
Practice Address - Street 1:2650 RIDGE AVE.
Practice Address - Street 2:DEPT. OF RADIOLOGY
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1057
Practice Address - Country:US
Practice Address - Phone:847-570-2477
Practice Address - Fax:847-570-2942
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2021-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL125.0679432085R0202X
IL0361519762085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology