Organization Active NPI

Daram H Reddy MD

  • Psychiatry Physician
  • Waukegan, IL
National Provider Identifier
1396723565
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DARAM H REDDY MD
Practice address
609 Greenwood Ave
Waukegan, IL 60087
Phone
(847) 336-2525
Fax
(847) 244-6799
NPI assigned
Jan 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Authorized official

Name
Mr. Daram H Reddy, MDNPI 1609895515
Title
Owner
Phone
(847) 336-2525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

609 Greenwood Ave
Waukegan, IL 60087

Mailing address

609 Greenwood Ave
Waukegan, IL 60087
Phone (847) 336-2525

Other identifiers 1

IdentifierTypeStateIssuer
036061866MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1396723565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 GREENWOOD AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "60087",
            "telephone_number": "847-336-2525",
            "fax_number": "847-244-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 GREENWOOD AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "60087",
            "telephone_number": "847-336-2525",
            "fax_number": "847-244-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARAM H REDDY MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-06",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "DARAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-336-2525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061866",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.