Provider Demographics
NPI:1700128287
Name:REID, RUBY UPADHYAY (MD)
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:UPADHYAY
Last Name:REID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RUBY
Other - Middle Name:
Other - Last Name:UPADHYAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 75103
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-5103
Mailing Address - Country:US
Mailing Address - Phone:973-882-3456
Mailing Address - Fax:973-882-3450
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:SUITE 1118
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-942-4500
Practice Address - Fax:312-942-2380
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012679512084N0400X
SD132032084N0400X
AL387942084N0400X
FLME1427812084N0400X
GA843032084N0400X
IL125.063168207R00000X, 2084N0400X
PAMD4688982084N0400X
SC831242084N0400X
DEC1-00133652084N0400X
NC2019023642084N0400X
NJ25MA107249002084N0400X
NY3009162084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine