Individual
RAVALI POREDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 E SUPERIOR ST STE 306, CHICAGO, IL 60611-2595
(312) 754-9404
Mailing address
1 E SUPERIOR ST STE 306, CHICAGO, IL 60611-2595
(312) 754-9404
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036.165560
IL
2084P0800X
Psychiatry Physician
2019022965
MO
Other
Enumeration date
06/26/2019
Last updated
06/29/2023
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