Active NPI
Sukanya Reddy, M.D.
- Family Medicine Physician
- Roselle, IL
National Provider Identifier
1891751210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 36051673
- Practice address
- 975 E Nerge Rd Ste N40
Roselle, IL 60172-4809 - Phone
- (630) 307-0660
- Fax
- (847) 437-4045
- NPI assigned
- Apr 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 36051673 | IL | Primary |
Addresses
Primary practice location
975 E Nerge Rd Ste N40
Roselle, IL 60172-4809
Mailing address
975 E Nerge Rd Ste N40
Roselle, IL 60172-4809
Phone (630) 307-0660
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036051673 | Medicaid | IL | |
| 01606888 | Other | IL | BLUECROSS BLUESHIELD |
| 363049360 | Other | IL | COMMERCIAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36051673 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gizunt SC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Chicago, IL
- NPI 1104951698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327622400000",
"number": "1891751210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "975 E NERGE RD STE N40",
"city": "ROSELLE",
"state": "IL",
"postal_code": "601724809",
"telephone_number": "630-307-0660",
"fax_number": "847-437-4045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 E NERGE RD STE N40",
"city": "ROSELLE",
"state": "IL",
"postal_code": "601724809",
"telephone_number": "630-307-0660",
"fax_number": "847-437-4045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDDY",
"first_name": "SUKANYA",
"name_prefix": "Mrs.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-25",
"last_updated": "2012-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "36051673",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036051673",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "01606888",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL",
"identifier": "363049360",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roselle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.