Provider Demographics
NPI:1811063761
Name:MADIREDDY, VISHNU (MD)
Entity type:Individual
Prefix:DR
First Name:VISHNU
Middle Name:
Last Name:MADIREDDY
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 1:1105 MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERWOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3512
Mailing Address - Country:US
Mailing Address - Phone:847-325-5110
Mailing Address - Fax:847-325-5114
Practice Address - Street 1:1105 MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:RIVERWOODS
Practice Address - State:IL
Practice Address - Zip Code:60015-3512
Practice Address - Country:US
Practice Address - Phone:847-325-5110
Practice Address - Fax:847-325-5114
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036091869207R00000X
WAMD61327419207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine