Active NPI
Daram H Reddy MD
- Psychiatry Physician
- Waukegan, IL
National Provider Identifier
1396723565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Daram H Reddy, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036061866 | Medicaid | IL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- Waukegan, IL
- NPI 1609895515
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.