Individual provider Active NPI

Surekha V Reddy, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1609969633
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Practice address
820 S Damen Ave
Mail Code 111
Chicago, IL 60612-3728
Phone
(312) 569-7028
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X IL Primary

Addresses

Primary practice location

820 S Damen Ave
Mail Code 111
Chicago, IL 60612-3728

Mailing address

742 Sarah LN
Northbrook, IL 60062-2172
Phone (847) 562-0899

Other names 1

  • Dr. Surekha Varidireddy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120622000637 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1850556911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609969633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 SARAH LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622172",
            "telephone_number": "847-562-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S DAMEN AVE",
            "address_2": "MAIL CODE 111",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123728",
            "telephone_number": "312-569-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "SUREKHA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUREKHA",
            "last_name": "VARIDIREDDY",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.