Provider Demographics
NPI:1649217829
Name:REDDY, NAVEEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:NAVEEN
Middle Name:C
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120W 22ND ST 200
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1563
Mailing Address - Country:US
Mailing Address - Phone:630-573-5000
Mailing Address - Fax:
Practice Address - Street 1:2340 S HIGHLAND AVE STE 160
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148
Practice Address - Country:US
Practice Address - Phone:630-495-9356
Practice Address - Fax:630-495-3770
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036111441207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036111441Medicaid
ILK27940Medicare PIN
ILI52637Medicare UPIN
ILP00328128Medicare PIN
IL036111441Medicaid