Individual
ANIL KUMAR REDDY REDDIVARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
(309) 672-5729
Mailing address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125053289
IL
Other
Enumeration date
07/22/2008
Last updated
10/16/2012
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