Reddy Dermatology, S Corporation

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

REDDY DERMATOLOGY, S CORPORATION

Practice address

412 63Rd St Ste 101
Downers Grove, IL 60516-2000

Phone

(630) 855-8355

NPI assigned

Sep 25, 2018

Last updated

Aug 31, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terence Chiramel, MBBS, MBA

Title

Administrator

Phone

(630) 855-8355

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lalitha D Reddy, MD

  • Dermatology Physician
  • Downers Grove, IL
  • NPI 1053306597
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1366927493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 63RD ST STE 101",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605162000",
            "telephone_number": "815-210-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 63RD ST STE 101",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605162000",
            "telephone_number": "630-855-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDDY DERMATOLOGY, S CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-25",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-24",
        "status": "A",
        "authorized_official_last_name": "CHIRAMEL",
        "authorized_official_first_name": "TERENCE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "630-855-8355",
        "authorized_official_credential": "MBBS, MBA"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederic Jude Ratio, DC
• Natalia M Ratulowska, ESTHETICIAN
• Jillian Rawl Giammona, MA, LCPC, NCC
• Daniel Ray
• Linda Sue Reckers, MA
• Akhil Surasani Reddy, MD
• Jissille Rama Reddy, PA-C
• Lalitha D Reddy, MD
• Linda Bailey Reding, RDH
• Ann Reed, L.AC., MSOM

• Dermatology Physician in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.